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Hey all. Haven't been on here much since my sx. Up until this past month I've thought myself to be kind of a model sleever. Logged everything, worked out 6 days a week. No bad foods, lots of water and protein. Steady loss each week without fail and no stalls. I've gone from 263 on sx day (11/10/16) to 186. For the last month though, I haven't lost a pound, and even gained (always would lose it and go back to that 186 though). I'm stumped at what it could be. Tried upping carbs a bit (I do a keto diet mostly) increasing water (I drink 80-90 oz regularly so increasing more hasn't seemed to do anything) and I eat 80-110 oz of protein regularly, and still stuck. Is my metabolism messed up? My calories are usually under 1100, and net carbs under 50. If anyone has any advice, let me know! My Nut wasn't much help; just said to wait it out. Is that the only thing to do? Thanks!

I began my WLS journey in 2015 with gastric sleeve surgery in September. My starting weight was 301, which I had managed to diet down to 285 by the time I was approved for surgery. Surgery weight was 277. Surgery was uneventful and I was back at my normal activities within a couple days. My goal weight was 185, but I only managed to lose down to 210. I believe this was because I made the mistake of continuing to drink alcohol after surgery (although less than before) and still ate too many snacks and slider type foods. Over the next several years my weight gradually increased until it settled in at about 230-235. Then the pandemic occurred and that added 20 pounds, so I was back to 255. This is when I learned what I felt was a good method to handle regain - I combined time restricted feeding with keto dieting... I only ate between Noon and 6pm, and strictly limited carbs. Doing this for a couple of months I was able to drop from 255 back to 235. I had issues with reflux before the surgery, and they continued after. They seemed to worsen as time passed. I learned not to eat at least 3 hours before bedtime, and still sometimes I'd end up sleeping in the recliner for several hours when the reflux was particularly bad. I also had developed a hiatal hernia (which a CT report said was small). Then in January of this year something changed. I started having issues where I could only eat a couple ounces of food without feeling severely overstuffed. This plus some bouts with chest pain prompted a couple of ER visits for cardiac workups. Finding no cardiac issues my doctors determined the pain was likely the hernia that had expanded. I also started experiencing symptoms that seem to be consistent with "silent reflux", such as throat, ear tube and sinus issues. I scheduled an EGD with my bariatric surgeon who found a 3cm hiatal hernia. He is going to repair it this coming Tuesday, and to prevent recurrence of the hernia as well as to resolve the GERD issues is doing a revision to RNY. I'm not happy about having to start over with the healing process, but am excited to finally lose the excess weight, correct the hernia and GERD, and get a chance to do things right the second time. So, here are some lessons learned along the way. If they can help someone else then this post is worth making: 1. Listen to your surgeon. If they recommend one procedure over another, there is a reason why. I probably should have done the RNY in the beginning but opted for the sleeve even though I had existing reflux issues. 2. Follow the dietary guidelines. They are there to assure the most successful weight loss. Unfortunately I 'taught myself' how to overcome the carbonation in beer and continued to drink it after recovery, which is a large part of the reason for lack of loss and regain. I wasn't addicted to either, but both were present in my social environment. I have now determined that alcohol and junk food are poison to my system and have resolved to be diligent in avoiding them. 3. If you do experience regain, get on it quickly. I found that time restricted feeding along with a keto eating plan worked wonders for me. I was essentially following the insulin control program established by Dr. Jason Fung. I quickly dropped close to 20 lbs using my sleeve along with this plan. 4. The sleeve, or bypass, is a tool that is given to you for life. You have a great window of opportunity the first year to lose weight and correct health problems. Make the most of it. Even though the tool is still there in later years, it becomes more difficult to lose weight after your system is fully healed and settled into normal life. It's possible, but harder. Make the most of the "one year honeymoon" window!

I haven't weighed myself since I came home from the hospital. I am trying to only weigh in twice month, just so I do not get too hung up on the numbers. I just moved from clear liquids to full liquids today but I was little afraid of that too, not because I have pain just because in my head I am telling myself it could be bad...lol I did get 2 shakes in today so I thought that was decent progress. I have my first follow up on Tuesday and I will weigh in at that time. My husband is set up for this next month and we set the winter aside thinking it was going to be a long process and kind of planned on some bumps so I am pleased he is seeing a smooth ride so he does not get nervous and chicken out. I hope this is the beginning of a smooth process and we all get to where we need to be. I am reading a lot about the Keto Eupohoria (not sure on that spelling) but I am almost thinking my energy may be coming from that. I am not complaining because I am knocking out end of year here as well!!!

Same here! I had great success with keto a few years ago, and so far I am replicating that success. I had to modify my plan a bit (everything I eat is approved, but I don't eat everything that is approved). I have lost 18% of my total body mass in 6 weeks. As a big meat eater anyway, it's a natural fit for me.

@tjgillman : first, congrats on all your hard work and weight loss! Though you may not think it, but a 100lbs (45kg) weight loss in 10 months is NOT slow. It is average to above average. Second, based on your height, weight, gender & daily activity, at a very high level, in order to lose weight you need to be taking in roughly LESS than 1800 cals a day (I got to this very general number using the calculator at https://www.ruled.me/keto-calculator/) Sooooooo.... if you are averaging 1300 cals a day, weight loss at this time for you will be relatively "slow" compared to before, when you were bigger Doing the math: it takes a calorie deficit from of at least 3500 to lose a lb. based on your stats, you need to get below 1800 to lose weight. you are taking in 1300 which means: every day, you have a deficit of 500 cals. sooooo... that means it will take you 7 days to lose one pound (3500/500) IF you are in fact taking in 1300 cals and are moderately active EVERY DAY. If you want to speed up weight loss, you'll need to create a bigger calorie deficit (which does NOT mean eating more nor exercising less) Good Luck! ...and again congrats on the weight loss, you are doing great!

Hello everyone! I'm five months post-op and have lost 55 pounds. My goal is to lose 10 pounds a month over the next three months if I can during the "honeymoon" period. I'm currently eating keto (high fat/ low carb/ meeting or exceeding protein goals) with an average of 1100 calories a day. I'm shooting for 1000 but 1100 has been the average for two weeks. I'm keeping paper food logs in addition to tracking in My Fitness Pal as part of new mindful eating therapy. On paper I also track when I eat, where I eat, my hunger level, cravings, and what the circumstances and feelings are. My therapist noticed that I wrote repeatedly how tired I felt even on days when I'd slept well the night before. Every two weeks I also have had something of a binge day (1500-2000 calories, usually high carb). The therapist told me that I'm exhausted and spiking with calories/ carbs like this because I'm eating too little and am going too many hours without eating. I eat three meals and a snack every day and am hitting my macros, particularly the protein. On that I range from 65-100 grams, usually landing at around 75 grams. Questions for you: is feeling so tired at this point normal? Is 1100 calories too low at 5 months? I'm in my late 40s and am 5'4". I haven't been exercising as much bc I'm so drained at the end of the day. I get in an average of 6,000 steps a day when I had been hitting 10-12,000 and eating about 1300-1400 calories a day. The therapist is encouraging me to tune in to what my body wants and eat what it wants, but I've always had a hard time knowing what it wants vs what I crave.

I suspect that at least of part of this is from the popularity of low carb dieting, as grains are one of the major sources of B1, and even for those who aren't big into Atkins, keto, etc., grain products tend to be but on the back burner for quite a while in favor of protein (a necessity) and green vegetables.

Are you still in weight loss phase? Keto snacks, while low in carbs, are high in fat, and still pack alot of calories.

So I'm actually enjoying working out!!! Who knew?? lol I work out twice a day. I do 20 minutes on the treadmill on speed 3.5 (running is 4.0 and I'm not there yet lol ) then I do 15 minutes on the bike at speed 12 (most resistance is 15, but again, not there yet) and 10 minutes doing sit-ups and stomach crunches. Those are the hardest, so I only do 5 minutes of each, but it's a decent start, anyway. I just finished my work out and even though I'm tired, I feel GOOD. Really accomplished and actually have energy. And even though the scale is moving slowly, I see a real difference. My size 26 clothes are too big now and I almost fit into size 24!!!! I haven't been in a size 24 since I did keto a few years ago. The lowest size I got to was 22. I can't wait to hit size 20 and know I did it!!! I beat my keto size and weight and this time it'll stick. This has been the hardest, greatest, most frustrating, wonderful journey I've ever been on lol

I have been struggling with my weight my whole life. It's always a comment from my parents, or my old doctor saying that I should eat more veggies and salads and run more. Or me trying fad diet after fad diet, or trying a "lifestyle change" diet like Noom or Weight watchers or Keto... but I always hover between 280 and 220 pounds. I remember once, I broke past my 220 pound curse... I got to 200 pounds even! "Finally! Progress!" I thought to myself, but a little voice in the back of my head came around. It was all the doctors I had ever seen come to torture me. "For a person my size, gender, and age. I should be between 100-120 pounds". Ok, so time to change up the routine, and try to lose more weight. I took weight loss pills, exercised harder, but the weight loss just stalled. No matter how much I tried I could not break the barrier. So. I am taking the plunge into weight loss surgery. I spoke with my PCP, and he said felt it would benefit me. It will help with my insulin resistance that is due to my Pcos (polycystic ovary syndrome), and lower my risk for diabetes and heart problems (both are health issues from my parents). I found a surgeon in the Tampa, FL area and I have my very first appointment with him in a couple weeks... so why do I feel like a failure? Why is it that I feel like I can try a new way to lose the weight on my own without having surgery? Why am I against the surgery? Why does it feel like I'm failing when I haven't even started? I just want to be healthy... I don't even care about being skinny... I just want to be able to tie my shoes without becoming winded. Or go to a theme park without becoming tired in an hour. Do I have many, many questions? Yes. But signing up in this forum has helped answer some of them... do I worry about what I'll look like after the surgery? Yes. But that does not outweigh my health... and I know this! But why on earth do I still want to cancel the appointment and try, for the millionth time, to lose the weight on my own? Why do I feel like giving up when I haven't even started? Am I the only one who feels like this? I can't be alone in these thoughts, right? ... truthfully I probably should save this discussion for the bariatric therapist; but I can't stop thinking about it... How did you all do it? How did you guys push past the intrusive thoughts?

After gastric bypass surgery, the amount of food you consume is minimal. Instead your body is using the stored fat in your body as fuel. According to the internet: the liver utilizes the fat present in the body as an energy source, producing “ketones” in the process. This is known as “ketosis” – and is the process from where keto diets get their unusual name. These ketone bodies come in three common forms; acetoacetate, beta-hydroxybutyrate and acetone. In large quantities they are removed from the body in the urine or through exhalation. [That is why it is so very important to meet your daily fluid goals.] Ketones can have quite a characteristic smell; they often make the dieter’s breath smell quite sweet and fruity, quite distinct from typical halitosis. Excessive volumes of acetone, however, can smell rather different. Acetone on the breath is most commonly likened to the smell of nail varnish remover. Source: https://ultradex.co.uk/ketosis-breath-causes-solutions-for-bad-breath/ Another symptom of ketosis that can be rather unpleasant is dryness in your mouth, sometimes accompanied by a slight metallic taste and an acetone breath. Now I never really smelled my breath after surgery. But others complained that my breath smelled like death itself. But I did suffer from something called dry mouth. I found that a mouthwash called Biotene corrected that condition. Now I do not remember anything like a Keto rash. After surgery my body looked like it underwent WW II. It was totally covered with bruises. The bruises were in part a product of the blood thinner I had to take for a few weeks after surgery to prevent blood clots. These will heal. But I did experience another condition. When you lose significant weight, you are left with excess skin. Nowhere is this visible more than on your face. I developed very fine wrinkles; almost paper thin crinkles, all over my face. I looked like I was a hundred years old. I think women have the upper hand on this problem. My wife told me to use Bio-Oil available in most drug stores. I apply a dab on my face each morning and I am good to go. I have been using this for over 5 years and it solves that problem.

I suffer from seborrheic dermatitis. Effects my face, scalp, and ears. Dry skin is a problem I have but this rash isn’t from dry skin. I followed an extremely low carb diet pre op. Stuck to protein first and good fats so somewhat of a Keto diet I suppose. Post op I followed the shakes, and liquids. My mouth becomes dry now, and there’s this constant like metallic taste I have. I’m constantly sipping either water or sugar free Powerade. The rash itself is red spots, itchy across my chest extending back on my shoulders and on my back. Thrush? That’s a mouth issue. Skin folds aren’t an issue in my chest? I don’t have wrinkles. I’m aware of blood thinner bruises I had those when I was given the injections to take after my c section.

They are meant to be keto and paleo friendly, low carb Sent from my SM-G950U using BariatricPal mobile app

I have thought about weight loss surgery for a few years and seriously for a year now. I've been overweight for over 20 years, and in the last nine years I have gained around 44 pounds. Currently I'm around 80 pounds overweight with a BMI of 37. Like so many here, I've tried so many things to lose weight. Meal replacement shakes, weight loss club, exercise, different kinds of low carb eating etc., with diminishing results. The last time I lost any significant amount of weight was almost decade ago, when I was pregnant with my son. I lost about 22 pounds from before I was pregnant, but I gained it back double in the years that followed. I was at my highest weight in 2019, and since then I've managed to lose and gain the same 10-15 pounds several times. Before I was a mom, I used to exercise regularly, but as a new single mom with a full time job, I didn't have the time. I started with a low carb diet four years ago and started exercising in a gym a year after that, but then covid came and all the gyms closed. I started having blood pressure problems at the end of 2019, and it has gotten worse since. I'm now on two different medication for blood pressure, plus Metaformin for blood sugar. I got covid last winter and after that my stamina is a lot worse, so I feel like I'm fighting an uphill battle I keep losing. I have the money to pay for surgery, if I go overseas to have it. I'm in northern Europe and am considering two private hospital in Eastern European countries. I guess I'm afraid of complications, of dying and of not getting the desired results. A part of me feels I should just be able to exercise and do keto to lose the weight, but I've tried it so many times and failed. As I said, I'm a single mom and want to live a long and healthy life for my son, who does not have another active parent in his life. I've only told one friend that I'm considering this surgery, but I hesitate to tell my family. I'm the only overweight person in my family and I'm not sure they'll be supportive. Did anyone else struggle this much with deciding to have surgery or not, and what finally helped you to decide?

@Biddy zz thks. Those r great suggestions. I just need to get it together n regroup. I need to do more meal planning. Yes that “Real Good Pizza co.” is a once n awhile thing but it’s basically no carbs which is why so many people r eating it especially those on Keto diets but yes I’m sure plenty of additives. Definitely no clean eating.

I like Lyle's articles a lot. I know that people think we need carbs for fuel but as a long time runner, I can run for miles on very little carbs and not conk out. Even when I have times where I feel shaky, I don't automatically reach for a carb because I know that protein can do the job. Then again, I do quite well on keto. Always have.

So today is my weekly weigh in day, and I weigh 349!!! It's the first time in 2 years I have been below 350 (1st time was when I did keto, but as soon as I hit 320 it literally came back up and I never lost a single pound after I went back to my original weight). I'm figuring out the food portions, timing, measurements and I think I have it down!!! You guys have all been so amazing with all the meltdowns, crazy questions, doubting myself, etc I've done on here (I know, I was a bit loco lol ). But I seem to be losing at a nice steady pace (5-7 pounds per week) and I have to say, I'm really liking it. I feel like this is much more sustainable and maintainable than when I was doing keto (and surprisingly, a lot less restrictive! ) I'm 7 weeks post op today and honestly, other than my scars on my tummy, I would never know I had surgery. No pain, no more limitations, no problems at all. I still have to be mindful of how much I eat and how often, because as I have said before, I never lost any of my hunger hormone. But I make homemade smoothies with fruit or I drink a protein shake if I need a little extra protein, or I just keep busy until I can teach my stomach and body that I'm NOT hungry and I HAVE eaten enough and I will NOT be eating anymore because I had my allotted amount and that's it. It's harder when you're still hungry, but it CAN be done. Especially when I see the progress on the scale. So so glad I had this surgery. I don't regret it at all. Not even a tiny bit. I just wish I had done it sooner. But I guess we all do, don't we? lol

I did keto as my 2 week pre diet but found it challenging because I’ve never enjoyed foods high in fats. They used to upset my tummy & reflux so I’ve been low fat for decades. I was also told keto should only be followed short term not as a long term lifestyle choice. I presumed the low fat recommendation post sleeve was because of the potential for gall bladder problems after surgery. Also my cholesterol went up to 6.9 during my weight loss as it was released from my fat. Thank goodness it’s back down now with a good balance of HDL & LDL.

This shows what a great weight loss toll testicles are! Yeah, guys do tend to lose more easily than gals owing to our normally higher muscle mass and metabolisms. Seriously though, this does point up one of the benefits, and downsides, of WLS - that we can lose well that first year with almost any diet. 20-30 years ago patients were often advised to "just eat like always, just less..." and they lost very well. Of course, they didn't keep it off as they didn't learn how to eat for long term health and weight control. The good part is that one doesn't need to go on one of those fad diets that we often see promoted online (keto, paleo, Zone, etc.) and can work to develop or maintain good dietary habits for the long term; the bad part is that one can still eat crap and lose - for now. Likewise, I like the idea that if he can't do it for himself, at least help you out and keep that junk out of the house.

Good luck Eric. I had the same problem - sleeve 3 years ago, lost 100 pounds in 8 months, gained back 60 over the next 2.5 years. I tried resetting my pouch and going back to pre-op diet mode, but nothing really worked for me. In the end I decided to have a revision to bypass earlier this year. I've been losing weight consistently (but slowly) since then. However, it hasn't affected any real change - I can eat just about anything (pizza, bread, pasta, whatever - serving sizes are normal portions, not bariatric portions). For the most part I DON'T eat these things (still doing shakes and fish and salad, etc.), but every now and then I've just been pushing to see if there is anything that my body does not like/can't handle. There's nothing. I'm really disappointed because I thought the even smaller stomach would help with portion control (it doesn't), that having bypass would make me not like sugar (it doesn't), or that I would have other food issues (like lactose intolerance - I don't). So it's a good wake-up call for me that portion control and what I eat is the key - I can't depend on the surgery to help me out, other than initial weight loss. For whatever reason, my body has reacted to these surgeries really well. In both cases I was up and walking and feeling great within a day after surgery, I never had food restrictions like so many others (I could eat at 3 months what many patients could at 2 years post-op), and I never had any food issues after surgery either. I'm saying all this in that the second surgery didn't fix any of my food/body issues, it's all a mind game, really. In a way I wish I hadn't had the second surgery (money-wise), but if I hadn't done it, I don't know if I would have learned these lessons as well. FWIW, I think the best plan for me going forward is a mix of protein-prioritized keto (or maybe paleo) mixed with intermittent fasting (I'll start with 12 hours and work my way down to 8 hours, maybe to 6 eventually), plus adding some weight training to my regimen. I'm working on weaning myself off of all my bad habits over the next week or so and will be starting fresh on July 1st. Hopefully others can chime in with what they've done to deal with weight regain after surgery. Unfortunately I think a lot of people who do tend to leave these forums (as I did), so I'm hoping that sticking around here on a regular basis will keep me more motivated.

Okay well I'm confused how you can't be losing anything? I personally have about double that amount of protein though and less carbs; like keto without the fat...

In today's world so many people have different eating plans ( clean, paleo, keto, gluten free etc). I had a lunch meeting this weekend and declined the lunch portion. I opened my Protein shake and said no thanks I'm doing lo carb/ hi protein right now. No one thought anything of it. Sent from my XT1565 using the BariatricPal App

I have been using Contractubex, I paid 60 at the Dr's office then came home and found it on ebay for 10, errrr. In the "scar stages" thread, there is a picture towards the end of the thread of a patient 14 days out. You can't even see her scars!! She used a product called Keto cote from skinstore.com and a homeopathic medicine called arnica montana (GNC). I have been taking the arnica and using the gel my doctor gave me and my scars look fabulous at this point. Don't waste your money on mederma or scarzone.

True. But we should also pay attention to history. If we've tried something in the past, and had great success that wasn't sustainable....maybe we need to rethink it? I'm not a stranger to keto, btw....I lost 50 pounds on it once upon a time in three months... and regained it just as fast. Keto made me feel wretched...I had actual dreams about food while on it, which was very weird...and my cravings for junk were incredibly intense and unpleasant. When I fell off the wagon, I kinda lost my mind...went nuts and made up for lost time. It wasn't pretty. You are dead right....to each their own. And I know some folks do have luck with high protein carb restrictive diets. But for me? Carb restrictive diets were a recipe for me to fall off a cliff. Also, my BUN went up (my kidney function suffered because they had to work so much harder dealing with all that protein) Not saying I haven't fallen off the wagon with my current diet....but when I do...the sensation is way different. I go a little off course, feel stupid, and don't have any problems getting right back in the saddle. I stall for a day or two, but don't really gain. Falling off Keto, I'd gain five pounds instantaneously and went completely out of control...it just snowballed. I will never do that to myself again. Great apes eat fruit, fiber and lots of plant based protein. I'm a great ape, not a lion.

Consider starting social media coverage of your changes like an Instagram low carb lifestyle or Keto journey (or whatever diet plan best represents how you will eat post op long term) Your dietary changes will be very public and everyone will see exactly what you are doing to lose the weight...