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I have always had a dilemma about the sleeve, because patients can expand their stomach pouch, by poor compliance. The majority of people who have bariatric surgery experience psychological problems with their relationship with food rather than a physiological problem. Therefore, not withstanding a brain transplant, I don't think a sleeve would be successful for such individuals. I think that's one of the main reasons for revision from sleeve to bypass. With bypass, this is my own experience, you can eat as much as you want, but you don't put on the weight. I feel sleeve is suited to people who need a helping hand to lose weight but are strong enough to comply with a lifestyle diet change. Those of us who would continue to struggle with our relationship with food regardless, I think are better candidates for the bypass. The bypass comes in various strengths. There are several variations of the bariatric gastric bypass surgery, including: 1. Roux-en-Y gastric bypass (RYGB) 2. Mini gastric bypass (MGB) 3. Biliopancreatic diversion with duodenal switch (BPD/DS) and While Roux-en-Y gastric bypass, mini gastric bypass, and biliopancreatic diversion with duodenal switch are the most well-known variations, there are other less common types of gastric bypass surgeries, including: 1. Single Anastomosis Gastric Bypass (SAGB) 2. Loop Gastric Bypass 3. Sleeve Gastrectomy with Transit Bipartition

Congratulations! I'm almost 4 months post-op from gastric bypass and my advice is to watch every video from Dr. Matthew Weiner (Pound of Cure Weight Loss) and Dr. John Pilcher on YouTube. These were by far the best resources I found, and I go back and watch many of them (especially Dr. Weiner's, and also his new podcast) all the time even now. Especially the ones on how to build lifelong behaviors to keep the weight off. One thing I did early on, right after my first bariatric appointment where I weighed in at my highest weight ever (yikes!) was order Dr. Weiner's books. There's The Pound of Cure, which gives a detailed, step by step way to make healthy changes to your diet, plus a second book explaining how bariatric surgery really works and then his bariatric cookbook (I also really like Bariatric Meal Prep Made Easy by Kristin Willard). I made several of the changes recommended by the Pound of Cure (I didn't start with the 2-week diet, just started implementing changes I thought I could manage) and over time I lost about 12 pounds, plus just felt healthier and more in control of what I was eating. One other piece of advice: don't over-buy protein supplements. So many people on this board will tell you this, and I did not heed the advice. Now my cupboard is full of protein supplements I stopped liking after surgery and will never use. I've barely needed supplements after the first month or so, honestly. I feel guilty at how much money I spent on them, but I will likely end up throwing them all away (most are opened so can't be donated). If you want to stock up on anything, an unflavored protein powder is much more likely to be useful to you in the long run than the flavored shakes. But if you're buying flavored ones, consider trying a soup flavored one because the sweet ones get old really fast, even pre-surgery. Oh, and take "before" photos! I know taking photos can be so uncomfortable, but you will want them. Choose something very form fitting to start. I went with a pair of exercise leggings and a tank top that was so tight it was like skin. I took photos about a week after my first appointment, so around my highest weight, and then on the day before surgery and at each month-marker thereafter. So far, I've worn the same clothing each time, although I may need to change that as it becomes too baggy to show the progress clearly. Take your measurements the same day you take your photos. You may struggle to see (or refuse to believe) the changes in yourself, but the photos and measurements don't lie. Even if it's painful to see the photos now, you will be so grateful to have them later. I was in shock and wanted to cry when I truly looked at my highest weight photos, but I'm so glad I took them.

So, I am graduating this May with my bachelor's and applying to law schools for this coming school year (2024-2025). One thing I had considered is going to a law school in another country (and staying there after for work), but I will be having my bypass surgery this April and I am unsure what bariatric care is like in the various countries (in Europe). The majority of information I keep finding is about where to go for the surgery, but I am curious about if I have any post-op complications (since I will be less than a year out when I would go to school) and the choices for bariatric vitamins and meal replacements. What experiences have any of you had while abroad with dietary and medical needs being a bariatric patient? I am also considering applying for the dual degree programs with the American law schools I am applying at and law schools in UK/France/Italy/Spain that I would apply for while in my first year, so either way I would like to know.

As per my reply on another of your many posts today.... Are you actually having (or have you had) bariatric surgery?? I see that you post a lot of questions but never actually give any details about yourself, your journey etc even when specifically asked by some of us. We are all open here and share thoughts and feelings etc yet, and sorry if you feel I am being rude, but you just ask question after question like someone trying to get information for a report or article and without you answering back it does not come across as honest.

If you don't already have some bariatric cookbooks, I can highly recommend these three of the several I bought: Bariatric Meal Prep Made Easy by Kristin Willard The Bariatric Diet Guide and Cookbook by Dr. Matthew Weiner The Easy 5 Ingredient Bariatric Cookbook by Megan Wolf All three have sound nutritional advice as they are written by bariatric experts, as well as some really nice recipes. They talk about portion sizes and what to aim for nutritionally as you go through the honeymoon period and into maintenance, and even give you different portions for different phases. None of the books give specific calorie goals, but that's rather standard with many programs. The focus is often for you to discover what works for you and not get sucked into a dieting mindset by counting everything so closely you drive yourself crazy. But the basics are generally to fill one half of your (small, child or luncheon sized) plate with a 3-4oz portion of lean protein and no more than a 1/2 cup serving of starch/grain, and the other half with non-starchy veg. Consume 60-80g protein. Drink at least 64 oz water. (Apologies for not having the metric measurements). Using a small plate is a really great visual cue. Check out the Portion Perfection plates, which are 8-inch melamine and printed with exactly how much of each food goes where. If you need to retrain yourself, this is an easy tool to use. They have bowls, too. (All the books and the plates can be found on Amazon in the US). Going back to liquids is extreme. I would think it would be sufficient to go back to three meals per day as described above, and either no snacks or only fruit and veg or a protein shake as a snack if truly hungry, and make sure you weigh your portions and get all your water in every day. The other thing is to look for processed foods that have crept back into your diet and get them out of your house. You can't be tempted by what isn't there. Good luck to you!

I don't live near a gym either and really don't want to go to one. I've been trying to do some YouTube videos, and I got a walking pad. Have you guys heard of "cardio drumming?" We did it at my bariatric support group and I started doing it at home too. I don't think I've ever walked away from any kind of exercise saying "that was fun" before this! I bought some wrist weights to use while doing it. I'll put a few links here... (Where they use 2 balls, I just hit the side of my one)

Great questions! HSA/FSA Payments: Payments made through HSA and FSA cards are not accepted. However, we are working on integrating this payment method in the near future, as it is currently in the product roadmap. About the Medications: We're excited to start offering compounded Semaglutide and plan to soon include compounded Tirzepatide. The decision to initially provide compounded options stems from our commitment to affordability without compromising quality. As the prices of branded versions become more accessible, we'll be sure to include them as well. Quality and Safety Standards: The pharmacies within the BariatricPal network uphold the highest standards of quality and safety, adhering to regulations set by state boards of pharmacy, the FDA, the DEA, and the USP Convention. This includes strict compliance with USP General Chapter 795 to ensure our compounded medications' safety, potency, and quality. Each batch of compounded Semaglutide undergoes rigorous quality assurance and control checks, including: Verification of Active Pharmaceutical Ingredient (API) Certificate of Analysis from FDA-registered manufacturers. Aseptic compounding processes to produce specific lots. Independent third-party laboratory testing for potency, sterility, and endotoxicity. Unique lot numbering and electronic tracking for dispensing. Post-Bariatric Surgery Considerations: The timing for starting GLP-1 medications post-bariatric surgery is a personalized decision that should be discussed with your bariatric surgeon or one of our telehealthcare providers. Individual needs and recovery processes vary, making it essential to tailor this aspect of your care to your specific situation.

Background.... I am a teacher in Missouri and not a single insurance plan covers anything dealing with bariatric surgery. Does anyone know of any supplemental insurance I could get that would cover it. I tried to finance but couldn't. Any info would be great. thanks

Still on liquids here but was scoping out a split pea soup recipe to make for purées - fingers crossed starting on Monday! The recipe said it makes a gallon of soup. The visual of me scooping 1/4 C out of the gallon of soup did make me laugh. Yes, bariatric cookbook too but I really like the book so am not complaining. Will definitely cut that one down… 😄. And freeze some.

Stretching in the sense that you mean it is exceedingly rare and only happens if someone consistently binge eats over a relatively long period of time. What does happen naturally is increased capacity. This is true for sleeve and bypass both. After 6 months or so, your stomach regains some of its elasticity and can accommodate a bit more at one sitting. This is fine and healthy. Everyone is different, and everyone's capacity at a given point post-op is different. I don't know what you were told for goals, but my program says 60-80g protein per day and 64oz minimum of water. They want my protein to be around 40% of my calories, and I generally aim for 800-1000 calories per day, but that was not strictly set and will change over time. 1200 seems to be a common goal for the later stages of weight loss, with the amount going up once you are in maintenance. 5oz per meal is reasonable, but you need to be eating breakfast, lunch, and dinner. Plus possibly a snack. My program says aim for 20-25g protein per meal, and supplement with a protein snack or shake as needed until you can get the full amount from food comfortably. By 9 months, you should be fine getting it all from food. Your brittle nails and hair loss suggest you are not getting enough protein and may not be getting enough other nutrients. You should continue to aim for around 4 oz of lean meat or fish, (or a serving of Greek yogurt or cottage cheese, for example) per meal. 4oz cooked skinless chicken breast has 25g protein. Your second priority at every meal should be nonstarchy veg. If you still have room, you can have a little bit of carb (rice, potato, sweet potato, bread, etc.). A serving of fruit makes a nice dessert. An easy way to eyeball it is to take a salad plate (not dinner plate), and put a piece of meat the size and thickness of your palm on one side, and fill about 2/3 of the other side with nonstarchy veg and the remaining 1/3 with carb. Go light on the sauces and butter. If in doubt, check Amazon for bariatric cookbooks. There are several by bariatric experts, including surgeons and registered dietitians. Kristin Willard's Bariatric Meal Prep is a personal favorite, with portion sizes for different stages, and a full color photo for every recipe.

Is there anybody that has marketplace insurance that covered Bariatric surgery? If so, what insurance did you get?

Hi there!! Thanks for sharing your experience! I will let you know that mounjaro does make my reflux worse!! because it slows down my digestion. It also causes constipation in some people. But if you don’t have these issues it’s good! I have not had it yet but I’m going to get vsg. However I do wish I could get the SADI but my insurance won’t cover that one. I have heard people do so well with the weight loss and reversing diabetes. It’s just expensive without insurance. But would if I had the financial freedom! Bypass is also very successful too! Check out some podcasts like “the skinny truth” or check out Dr. Roller’s instagram. I listen to “Core Bariatrics” and “The Bariatric Grind”! They’re good listens in the car and super informative. Of course following your trusted surgeon’s recs are #1!

In case you would find this helpful, Dr. Weiner's bariatric practice in Tucson, AZ has started a virtual nutrition support program that is open to anyone, no matter where you live or where you had surgery. You get unlimited access to monthly classes and support groups for $50 a month, and members can book a personal appointment with the dietician, Zoe, for $20 per session. Since you don't have anyone you can rely on from your surgeon's office, maybe this would be a useful resource. Here's their link: https://www.poundofcureweightloss.com/nutrition-counseling-memberships/

I don’t personal buy it on bariatric pal, but might look into it. Before my surgery I bought some protein soup and protein pudding on Amazon. I picked the one that is bariatric friendly like low in carb, and low in sugar. The protein pudding I tried the variety pack first, but the 0 sugar one didn’t taste to my liking and I bought the one I like that have 2garm of sugar in it. The soup and pudding have extra 12-15 gram of protein. I only use it when my meals does not meet my protein requirements and it can give me a boost, or I use it when I am craving dessert. It does help a lot for me. But I had only used 2 time after surgery. I used it more when I was in my pre ob liquid diet.

Had gastric bypass Feb. 7th. My food intake is hot and cold at times. The last few weeks I've felt like I needed to eat more often. Not more volume, just spread it out more to fuel myself. I've been exhausted lately. I think spreading out my meals has helped some. You should try the baritastic app. I've used that since October. The dietician at the bariatric center can see the food and drinks that I log. But it's a good app just for yourself as well to keep track.

For those that are interested in this, is HSA and/or FSA accepted for payment? Is this compounded and not the commercially available stuff? How long after you have bariatric surgery do you have to wait before you can take this medication?Personally, I won't be partaking, but I've seen many posts on here from others who want to, so I was just thinking of questions that weren't mentioned in the original post.

So I read in todays newspapers that a beautiful young girl of 20 went to Turkey for Bariatric surgery and became very ill on the airplane home. She paid Dr. Bayil of Global medical care, £2500. Eye wateringly cheaper than the out of pocket cost in UK. I paid £12000. two years ago. They diverted to Serbia but sadly she died. The surgeon had nicked the intestine. He is saying he did nothing wrong. He said 'It was an embolism caused by the plane. ' An autopsy found the intestinal laceration. I wish bariatric surgery was easier and cheaper to get in our own countries. RIP Morgan Ribeiro

I use the Baritastic app. It tracks food macros and fluid intake. I track EVERYTHING that goes in my mouth, even condiments and coffee. LOL It helps immensely with staying on track. My Apple watch doesn't help with intake. It helps me remember to stand hourly. It counts my steps. It annoys me with messages all day. It reminds me to take my meds and vitamins. But it doesn't help with meals. Though there might be something to set in it to help with that? I just don't because my meal times vary a bit depending on when I wake up and eat my first meal. I highly suggest you get a pill case and dose out your vitamins for the whole week, or in my case, the whole month! A dietician can provide you with a list of supplementation or you can hunt down the ASMBS guidelines for your surgery, that's what most good dieticians use. It sounds like you may need to be watching your protein, fat, and calcium intake. Many people a few years out from the various surgeries start to show nutritional deficiencies if they haven't been keeping up with their protein intake and supplementation. Good hydration is important too. If you can, it would be wise to go have bariatric labs drawn, your GP can do this if you aren't still seeing your surgery center. A bariatric practice could do this too and would be good to follow up with if you are struggling with regain and getting back on track. You can do this!!

Do you all buy any of bariatric pal foods? I’m about 3 days away from my 4 month post op. The bariatric foods hep me a lot to stick to my 60+ mg of protein a day still drink one shake a day because I get about 40mg protein in one shake. I usually drink around 4-6 pm so with my meals and snacks. I get the rest or more of protein through out. I too have sm stalls depending on if my right leg is swollen or I need to have a good bowel movement sorry TMI but I’m on pain management with chronic constipation. But I’m losing steady not as fast as first surgery but since I’m more sedentary then prior it’s expected but losing. Day of surgery was 304 now 272

Baritastic is a great app for tracking your food and it is made especially for bariatric patients!! It will track your fat for you as long as you enter everything you eat for the day! And it even has recipes in the app you can try...

I have logged my weight like that but never thought to add the big life stressors or events in between. I bet that would be helpful for a bariatric therapist if you see one. I am working on getting in to see one. I had gastric sleeve three years ago and gained all my weight back. I am contemplating a conversion surgery and I want to pull out all the stops this time around. Best of kick to you.

First, there is no one right way to eat to lose or maintain your weight. There’s just the right way for you. I agree to the suggestion to get in contact with your old dietician or find a new one. I’d also teach for a couple of weeks just to check your calorie & nutrient intake. I’d also get in contact with your surgeon as well to see what other options you have - revision surgery or maybe GLP - 1 meds. You’ve likely reset your body’s set point. The surgery lowered it but returning to larger portions, poor food choices & bad old habits have raised your set point again. So you’re actually fighting your body now. You’re trying to lose weight & your body is doing all it can to hold on to it. Have a look at Dr Matthew Weiner’s Pound of Loss metabolic reset diet (not that I’m an advocate for any ‘diets’.) It may give you some ideas you could try to see if works for you. He’s a great source of information around all things weight loss, bariatric surgery, etc. (He has a website & a you tube channel.) If you like being active, I’d add in some weights. Building muscle will help burn more calories & help counteract any muscle loss you experience while losing. Walking will help with general fitness. Remember though, activity only contributes to about 10% of any weight loss. Oh & don’t listen to your family & friends when they offer advice about your eating, nutrition or weight loss. They mean well but unless they’re qualified nutritionalist, dieticians, bariatric surgeons or medical doctors or had bariatric surgery they really don’t know what they’re talking about. And they’re not you. You know yourself best. You know your psychologically, physiologically & emotionally self best & know how you want to live your life. All the best.

If you're allowed, I found heating up a serving of tomato soup with unflavored protein powder was much more satisfying for my dinner than a shake. Just check that the combined calories and carbs of the soup plus the protein is roughly in line with a meal replacement shake. I used the Tomato Basil from Pacific Foods with 2 scoops of Syntrax unflavored and it was right in line with a Bariatric Fusion meal replacement shake but with a hot and savory flavor instead of sweet/cold.

Holaaaaa! I just wanted to ask if some of you never actually tracked down your food after your bariatric surgery ? Does it work ? Did you gain weight again ? I know everybody is different, i'm just trying to learn about other people's experiences !

Hello, I am new and want to introduce myself. I’m Gina and I am 13 days post op. I had the SIPS procedure and hiatal hernia repair. I had Gastric Sleeve in 2019. Reached a plateau, switched from Kaiser to United Health Care - Sutter Health (N. Ca). Five years ago my pre surgery weight was 286. My pre-op weight on January 10 is was 230. When I was still under Kaiser, I contacted my bariatric team about having revision surgery and they advised me to just stick to a thousand calorie diet and that I was not eligible for revision surgery. My family and I had to switch healthcare providers and I joined the weight management in nutrition program at Sutter Health, and I was immediately referred to a Bariatric surgeon who recommended a revision! I was pleasantly surprised, because I was not even going to ask because of my experience with Kaiser. So here I am 13 days post surgery and looking forward to reading about your experiences. 🙂👍🏼