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I have yet to see a nutritionist or dietician that truly understands the optimal diet for a SADI or DS patient. Most of the time we just get a modified version of what they give Bypass and Sleeve patients. But as you say, you aren't absorbing as much as they are, therefore to give you their requirements would leave you malnourished. 15 grams of fat is absurd by all medical standards. Most medical studies show we need 60 grams of fat for proper hormone function and even if you ate 60 grams of fat, with an altered digestive tract, you aren't absorbing that much, so you need to eat a little more than that. Even the ASMBS recommends 60 grams of fat by 1 year out!! Your dietician is not following best practices. Most SADI/DS patients I know follow the vets that have been living with this surgery for 10+ years and maintaining their weight loss. We figure they know more about optimal diet than a surgeon who has never lived with this surgery, or a dietician that has never even researched best diet for bariatric patients of various surgeries. Most patients I know are eating 100-120 grams of protein, less than 50 grams of carbs, and over 60 grams of fat, usually around 100 grams of fat for SADI and 150 grams for DS. You can increase your carbs once you have reached your goal weight, they tend to slow/stop weight loss, so in active weight loss it is important to keep them low so you stay in ketosis. A calorie range makes dieticians feel better, but it makes no sense for a SADI or DS patient because we malabsorb so much fat we can't even begin to properly calculate our calories. You could eat 1200 calories, but that wouldn't be what your body is absorbing. I'm sorry this is so complicated. In the end you have to decide what you feel best at. I don't feel good following guidelines like your dietician gave you and when I go over 50 grams of carbs I stop losing weight. So...yeah. I'm going to follow what allows my brain and hormones to function, what makes my skin, hair, and eyes feel best, what gives me the most energy, and what allows me to lose weight steadily. I'm the one that has to live in this body. It is sad these surgeries are so uncommon there are no good studies about optimal nutrition for them. But there is no way I'd go below ASMBS guidelines, they are the closest thing bariatric surgeons have to a standardizing body. Your dietician should be able to give you ASMBS guidelines for your surgery.

I travelled internationally two months ago, and was 6 months post-op. I brought protein bars, protein-enhanced electrolyte water mix packets, an empty water bottle & coffee cup, and snacks like a nut-based trail mix that I like to put together. I also hauled a giant plastic container of protein powder with me because I LIVE for my morning proffees. No problems crossing any borders or with any airports/security checkpoints.

So I finally got an email back from My dietician and the macros she gave me for diet post Sadi is 1000-1200 calories 90g protein 90g carbs and 15 grams of fat. That doesn’t seem to be anything close to yours. I am so confused and wondering if she is wrong. I feel like if I don’t absorb a descent pirtion of that I would be malnourished.

Okay so I am still so terrible with this stuff but my dietician makes it seem so much more confusing and I really need to understand this so I can get it right this time. I asked her what my requirements would be post SADI surgery and she said 1000-1200 calories 90g protein 90 carbs (45 fruit and veggies and 45 from starch), and 15g fat. I am trying to eat similar to that now to see what it’s like and I am logging my food. I figured my portions will be a little larger so I won’t be able to hit the exact goals but wanted to see where I am. This morning I did great with my protein iced coffee which is just a caramel shake with some coffee mixed in. Low calorie and carb and high protein. This afternoon however I thought I would have 2 scrambled eggs and one Turkey sausage Patty. The calories and carbs are fine but it seems like Either that fat goal is unrealistic or the protein goal is from normal food if there is really 15g of fat in two scrambled eggs and only like 13 grams of protein? Even if I forget the 7g of fat leaving out the Turkey sausage just two eggs is too much fat for one meal and reduces the protein. I hate egg whites but assumed two scrambled eggs would be okay. I know post surgery I will not eat two whole eggs which will reduce the fat some but also the protein. Could i add protein powder to the egg or something? Maybe an egg and a yogurt would be a better option? Or Do I have to just suck it up and eat the egg whites. She also said something about three teaspoons of “healthy fat” and I’m not sure if that’s in addition to the 15g of mono and polyunsaturated fat or if 15 is the total which may be where I’m getting confused. I just emailed her asking for clarification but last time it took her like two weeks to get back to me so I figured I’d see if anyone else can make sense of this.

Thank you so much!! as of now I am weight lifting 3-4x a week. Trying to switch up the exercises for my upper body and lower body. I do want to build a booty so I focus lifting heavy on those LOL. I agree I may need to eat more which I have been trying to incorporate more protein. I feel like this whole thing is a science and well I got a C in science so I am not sure what I am doing is hindering or helping. Like you said weightlifting and cardio are so good for us! I am sure I will see the difference in my body with inches as the time goes on. Loved the book/lecture

The thing is that they assume that you can only eat so much so if you prioritize protein then veggies then you should only be able to eat a tiny bit of healthy starches, if any, and based on that theory everyone will be okay. When I had Sleeve three years ago I swear mine was left larger than most though because I could drink and eat more from day one than they said I should. I always said that I know I had surgery because I could no longer get my moneys worth at an All you can eat buffet but I could still eat quite a bit. When I was back to “regular” portions I hit all my protein goals then ate my veggies like suggested but still had room for more carbs than I should be eating. I did great in the beginning when I was told how many ounces I should be eating and I wasn’t hungry so I just stopped myself there but later on I think I needed more guidance than just calories and what to prioritize. I know I was an exception to the rule though. When I went back to discuss revision with another dr he said not that I’m suggesting it but if you were eating a sub how many inches could you eat and when I said 5 or 6 easily he said that I should not be able to eat that much. I believe that is why things went wrong for me. I reached my first easy goal I set to encourage myself but never made it to my ideal body weight. Then a few month later when actual hunger came back and I ate until I was full I started to gain even with the healthy options because of my portion sizes. Admittedly if I had not been frustrated and basically gave up at some point I probably would not have gained ALL my weight back and I would still be healthier now than when I started, but I know where things began to go wrong so this time I asked repeatedly until I got even more guidance from the dietician.

How is everyone doing now? I had my surgery February 20th. I'm faring pretty well. Still some pain. Feeling like I need to eat all the time. Holding myself to food every hour to 2 hours. Very small amounts. Getting my protein. Starting a food diary tomorrow.

You being able to drink more fluids is not due to your tummy being bigger. You probably are not having as much internal swelling as someone else does. Also, some never lose their ability to gulp a good bit of water, and you don't list your surgery, some bypass patients also have this happen. Fluids exit our stomach really quickly, some faster than others. The restriction with fluids early on is because of the internal swelling and how long it takes to get to the stomach through that swollen area. I had a LOT of swelling. Water went down at a trickle. I could literally hear it displace air in my stomach when it finally got there, like a little drain finally clearing. It was hilarious and so strange feeling. For me it took 3 weeks for this weirdness to stop. I can take a good 3-4 full swallows most days now before I get pressure from my tummy to slow down. I tell you all this because I know for a fact I have a larger sleeved stomach than most, my surgeon made it that way due to reflux. I've seen it empty fluids on imaging, it is fast as lightning! LOL Your tummy will not lead to bad food choices, even if it were bigger. But your mind will! Trust me, once you add solid proteins in, you will probably feel your restriction to some degree. Many never feel restriction with purees and fluids.

For the first month, hydration is king. Calories are nice. Protein is good. But dehydration is the number one reason for ending up in the hospital post-op. Your family should be told about that. Aim for at least 64 oz a day. You may not get that at first, but after a few weeks of trying you will. For the first two weeks I felt like I was constantly drinking---and I was! I couldn't tolerate protein shakes or anything like jello or pudding, I had stomach spasms pretty severe the first two weeks. I could only get down water (which I had to flavor with sugar free flavorings to get down) and sugar free popsicles. My surgeon said that was okay. We have protein stores in our bodies to get us through the first few weeks. But it is still good to aim to get protein in as much as your tummy will allow. And I took my meds one pill at a time, spaced out throughout the day. Your family clearly loves you and are concerned, but only YOU know how you feel. It's okay to remind them of that. If they need more info they can read your packet from the surgeon or come read posts here. 😂 You'll get through this. Just keep sipping!! 💚

No actually. I was in Puerto Vallarta and there was never actually any concern with the water at any location. A lot of places do have bottled options, but even a few spots w regular water just served at the table or ice in drinks were just fine. There were 7 of us all together, just myself with surgery, and we were all fine.

Hello, I want to preface saying I have not had my surgery yet but I have been losing weight in the pre-op stages as per my dietitian and doctors request and this includes me going to the gym and getting my protein/calorie goals in for the day. The important thing to know is plateauing is inevitable as your body gets used to the things you do on a daily basis. So since you know that already you going to the gym is a beneficial first step in the right direction of losing more weight. That being said weight training is an amazing cardio/full body workout and for women you actually don’t have to worry about getting “bulky” my doctor said it’s just not what our bodies do to get stacked like that (he didn’t say it in those words of course but I’m paraphrasing). Which it’s true generally unless you’re a bodybuilder you won’t get bulked up like crazy (even then it’s usually the addition of hormones that add to bulking) so go ahead and lift girl! Cardio exercises like running, swimming etc. are also great to get into your routine which I see you have and it’s important to also not forget about aerobic exercises like yoga/pilates this will also minimize your chance of getting “bulky”. Overall, I would say if you have set days of the week you work out like MWF do that for 2 weeks then switch up the days, intensity of workouts and type of exercises you do on each day to give your body that “restart” it needs in order to start losing weight. It is also so incredibly important to eat enough calories! Yes sounds weird but you actually might not be eating enough for you to lose weight and this is what my doctor told me. If you don’t eat enough your body goes into “survival” mode because it’s not being given enough food in order to carry out your bodily functions to its fullest potential. Yes you can be taking supplements and be healthy on paper but if you’re trying to lose weight and exercising and eating well and still unable to lose the weight then it’s time to evaluate if you’re eating enough during the day. I would highly recommend reaching out to your doctor and/or dietitian about adequate dietary input your should have because there are all kinds of info and pamphlets on lines telling us to be between so and so calories at this point in time or to not exceed x amount but in reality everyone is different and all bodies are different. I hope this helps sorry for the book/lecture.

Personally, I do actually have loads of luggage space since I plan on bringing 1) lots of cute outfits with me and 2) many many MANY souvenirs back home. Plus buying the tickets months in advance has made it easier for me to upgrade the luggage since there’s no way two weeks worth of clothes were all gonna fit in my carry on since we plan on adventuring and going out all across Lima. One sole/sol is about 1/3 USD so definitely cheaper to buy stuff over there the only thing I really thought about brining is protein powder/shakes but then I feel powder might freak TSA out too much. 😂

Thank you all for your input and help! I don’t feel hunger or crave any foods right now. I just want to be left alone and just drink water when I wish to, eat something when I think I may want to. I’m not getting my calorie intake and no where near my protein intake. My parents are forcing again and again that I need to drink more and take all my meds etc. I know I need to but I have been taking them spaced out given o can’t just swallow everything at one time, it makes me sick. So anyway, it’s nice to know I’m not the only one who has no “hunger” out there. Thanks everyone.

No personal experience of travel in South America but I've had loads of holidays whilst on my post op diet. Honestly if you stick to protein first, veg second and carbs last (by a long way) I think you can travel anywhere in the world. I hope you really enjoy your vacay.

One of the biggest adjustments I had to make post op was to eat because I needed to, not because I was hungry. I actually never lost my hunger post op, but in those first few weeks when all you can consume is liquid, it is a struggle to get everything in. As soon as I moved to purees I started eating something every 3 hours when I was awake. Everyone's interval is different. Some can do just 3 times a day, but for me if I got over the 3 hour mark I'd start to get shaky and irritable and completely crash, it was clear I needed food, even if food was just a shake or a protein yogurt. I'm 6 months post op now and this has eased and I can go a little longer, so I follow my hunger cues more now and mostly eat at normal mealtimes with snacks if I'm up late or up early. But in the early months I just couldn't do that.

Welcome!! I had a friend who had bypass about the same time as you did and it was very different back then!! We have so many more resources available now. And SO many more products!! I remember how much she hated adding protein powders to her food and how stubborn she was about ignoring healthy food. She lost a ton of weight but I often wonder if she regained since she ate such junk post op. Eventually the portions catch up with you! Most advice for losing weight a while after surgery is to go back to basics, watching your portion size, cutting out simple carbs, getting most of your calories from healthy complex carbs, a little fat, and a generous portion of lean protein. Eat your protein portion first, your veggies second, and a few bites of a healthy starch/carb last, if you still have room. Get in whatever good movement you can. Drink at least 64 oz of water and for bypass patients I believe your protein per day should be close to 80 grams. You'd have to ask your doctor about your calories though. Do you still feel your restriction? I know with bypass they can do testing to see what your pouch looks like and hernia surgery is a good time to revise it if it needs a revision. I just had a hernia repair. I'm about 6 months post op from a Duodenal Switch. The healing process after hernia repair has been a lot like bariatric surgery. I can only eat liquids and some purees at the moment and I'm a week out. But I'm so glad I had the repair done!

Hello and congratulations on your surgery date. I travelled a few times in Europe in the first 6 months. I too looked for advice on here. There they had many protein products easily available. I supplemented the hotel food with protein yogurts. From the buffet I was ok with omelettes, bacon, beans and tomatoes. I found soups, deli meats, cheeses, fish and minced meat dishes ok for my evening meal. At that time I couldn't eat chicken, rice, pasta, potatoes, salads and pastry. For the most part they are still off my menu. Everyone is different in how they recover from this surgery. By then you will know your own routine. You will have plenty of energy to do all kinds of activities. My calories were very low at that time so I had energy and then it quickly ran out and I would go for a glass of milk or a milky latte to perk me up long enough until my next meal. I took with me jerky, nuts, cheese snacks and protein bars. You could take protein powder to add to your food. If you can get to a large supermarket, you will be sure to find protein drinks and protein yogurts. They are popular the world over now due to body building.

Welcome to the group and congrats on the upcoming surgery and all the pre-op success. I have not traveled to Peru, but I did go to Mexico about 9.5 months post op. Honestly it wasn't difficult at all. Typically by 8 weeks you should be healed on the inside and cleared for pretty much all movement. So by 6 months you'd be fine - generally speaking. I would say just packing all your vitamins and supplements is key of course. I also packed snacks mainly for the actual travel part - plane and car rides. I had jerky, cheese crisps, protein bars, portioned nuts and low carb chocolate. I had more than I really needed, but it definitely helped to have options. You could also consider protein powder or shakes in case. Also a reusable water bottle/cup comes in handy to ensure you stay hydrated. I stayed at an all inclusive resort and there were many healthy fresh options for all meals. The buffet breakfast had a ton of fresh fruit and veggies, a bunch of egg options - egg whites, hardboiled eggs, etc. and the meat protein options, yogurt and cheeses. There were various milks both dairy and non dairy options. Dinner menus had accommodations for different dietary needs. Off resort also wasn't difficult to navigate as there is a lot of protein and veg options. I found getting in movement was not difficult either. There was a gym, aerobic classes and water sports. But honestly walking around the resort, the pool, walking on the beach, the walking tours off resort - i never missed an exercise goal. The variables can happen depending on the area you are staying I'm sure, but I have friends who frequently travel to Peru to visit family and frequent many local cafes that have plentiful healthy options - healthier than you find in the states unless you grow it yourself since a majority is local and doesn't have to travel far at all. You will not likely be able to get exact specifics of macros if you like to track your food, but by 6 months you'll have an idea of estimated protein amounts and general portions for most foods you are likely to eat. As long as you stick with protein first, then veg and carbs last you should be good.

That does sound filling! I just love my Protein cold brew LOL So its possible that a protein bar a couple of hours later which I have been doing with the Rxbar and its been filling. I will have to look at some other recipes for cold brews see if I can beef it up. Thank you for the suggestion!

If all you're having for breakfast is a protein cold brew, that won't stick with you for long. I have a smoothie in the mornings and it packs a good nutritional punch. I recall even from before surgery that a smoothie would keep me going until lunch. My new go-to, after some trial and error, is 150g frozen fruit, 30g baby spinach, 1tsp each of hemp seed, chia, flax, and raw sunflower seeds, 100g drained and rinsed canned beans (cannellini, white beans, black beans, chickpeas will all work), plus 2 scoops unflavored protein (20g), a scoop of beetroot powder and a scoop of Benefiber. I fill with as much water as my 20oz blender cup will hold. I add a squeeze of the bottled grated ginger to kind of mask the bean flavor, and I blend the heck out of it with a Vitamix so it's really smooth. It's about 360 calories, 30g protein, and has 16g fiber (11 from ingredients, 5 from Benefiber). It takes me about 45 minutes to drink it at 9 weeks post-op.

This has also been a big concern for me, but my Peruvian family has been very supportive of my decision. My boyfriend is also Peruvian and supportive of this decision, but we plan on visiting Peru when I am 6 months post op (surgery date for June 13th 2024). This will be my first time in Peru since I am from the US and we plan on doing a lot of walking around Lima, Callao as well as touring Huacachina, Ica and Las Ballestas. If you are still active on here do you have any insight now on how your relationship with Peruvian food has changed? I plan on staying as safe as I can abroad so making sure things are cooked thoroughly, no tap water, only peeled fruits/veggies that are thoroughly cleaned. As well as portioning when we do eat out we plan to share dishes, I will try to order vegetarian options when possible, and if I have to/want to order my own plate I will ask for a to go box right off the bat to make sure I dont eat too much due to like you said the massive portion sizes.

So, I just completed day 3 of my liver prep diet. Today seemed to be better than yesterday. I am not feeling as hungry, although I am already getting tired of the protein shakes. I still have little energy, just doing the absolute necessary and resting a lot. It's hard but not horrible and will be worth it when all is said and done. Everyone hang in there and remember what the goal is... better health and a longer life. I'm still nervous, but also ready to move forward. We got this!

5/10. Im a bit nervous. Also a failed lap band from 2010 :( but my team is great and im envisioning a healthy future to keep me motivated. I packed lip balm. Moisturizer. Earplugs. Phone charger. Don’t plan on being there long and come home in same clothes wore in! The dietitian said not to plan on liking any protein shake i liked preop so be careful what you stock up on. I seem not to mind any of them so it will be ok! New to posting and talking about all this.

Long story short - had gastric bypass in July of 2019. Highest weight 400. Current weight 167 to 173. I still feel some restriction to this day. Meals are small and I don't eat high fat, high sugar food. 2 yrs ago, I started having right sided pain. It felt like ovarian pain so saw OB & had 2 ultrasounds nothing showed up there. Pain worsened & had gall bladder removed 1.5 yrs ago. Adjusted diet again to deal with gal bladder being gone and things seemed ok. A few months after the right sided pain returned. About 4 mos ago, pain got so bad at times I'd be in a ball on my bed considering going to ER (which I HATE doing). Went back to primary got CT scan. Nothing found. findings. Then he referred me for colonoscopy & upper GI. I thought finally 'this was it, we've ruled out most other things'. I also had seen blood in my stools and it was old blood, like coffee grounds so I thought ok, not hemorrhoids? Just got back home from colonoscopy & upper GI. Good news is no polyps or other concerning things. Bad news is main finding was on bypass "Patient's surgical anastomosis noted to be widely dilated, raising possibility of Dumping Syndrome as a cause". OK, we know what dumping is. Thought it was post surgery when we ate food (i.e. sugar, high fat) that processed too fast, etc. & you had dumping. Is the type of dumping they mention different from post surgery dumping? They recommend I see revision specialist. Has anyone else had revision NOT due to 1st bariatric surgery not being successful but for a "medical reason" like this (other than GERD, heartburn). I'm not even sure insurance will pay, but I have 2 yrs worth of history on this. Even it if does pay, I dread what this means - more hair loss? If I do this, will I need another in 5 yrs?. I also still feel restriction kick in although yes, nothing like 1st 2 years My highest weight right now hovers at 173. I hoped I'd get to 150 but closest I've come is 167-168. Is revision another 'nuclear detonation option'? ANYONE have a revision specialist in the North Texas area they can recommend so I can at least get a consultation (north texas = Fort Worth, Dallas, Arlington, Keller, Bedford, Euless, Hurst and Denton) I've also wondered if there is a chance of some straggler/stone from gallbladder surgery 1.5 yrs ago that should be considered? Any input would be appreciated. This is causing issues on my job as the pain hits out of nowhere (not X amount of time before OR after a meal, that I have been able to discern. Thank you!

Week 3 Post Op Sw: 155kg / 341 lbs Stats to date: - 11.6kg / 25.5 lbs I hit 3 full weeks post op yesterday and met with my surgeon + nutritionist So far so good, nut is happy with the progress i’ve made and have given the ok to move to solid food no restrictions. We looked at my hydration levels, all are good thank god because this particular subject is one of my biggest worries ! She gave me some ideas to up my protein but told me it’s quite normal to not be getting protein in yet and that month 2 is generally when you can build on that. We talked a lot about actually going up in food quantities. She told me that i should be eating 150g meals from month 1-3 then around 200 g from 3-6 months and ending up at 300g meals (standard portion size) from 6-12 months. She explained how to start adding quantity : adding one more spoonful per week. She and my surgeon are both pretty against weighing food they want me to start eyeballing as they both say the goal is to be able to live a normal life and be able to visually know one’s serving. Not sure how i feel about that and the whole upping the quantities thing is scary right now … we’ll see. My surgeon is completely happy and has provided my estimated weightloss curve. He estimates per his calculations a loss of around 60kg in 12 months - fingers crossed. He also gave me the ok to got back to work earlier than he had anticipated - but with a warning that i need to take particular care in having my daily vitamins because work means being more active and more fatigue. He did however not clear me for any physical activity on top of work. I work in an airport so i walk a LOT daily and he doesn’t want me to add more activity on top of my above average daily steps. I’ll be back in his office at month 3 now so early july ! I am officially stalled and have been for around 5 days so far weight wise which is expected and i’ve decided to just put the scale away and check back one week from now. I have survived my first ever restaurant with my boyfriend - and it went great ! I ate very slowly and was able to adapt my portion and my meal (steamed salmon and 1 baby potato) Incidentally we had a little conversation about his exclamations of « is that all you’re having are you sure, are you really sure » and i realised it’s strange for him to be seeing me eating so little and he has this kind of guilt about going all out and eating big portions. It made me feel ssooo good to get back into « normal » life, even at work i packed a snack box of individually portioned snacks (16g cheese slices, 30g watermelon, 30g strawberries and then a lunch of tuna salad and 3 crackers). It was so much easier than i thought to actually get into a real life normal routine - i love it !