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I was doing a Keto like diet (was not hitting the fat goals) then I went on vacation and it was shot to hell So I'm doing a low carb plan but nothing like before. I didn't notice any gained weight as a result of the switch however I am in the early months of post surgery my body seems to enjoy the fruits and vegetables more than the proteins (I was a vegetarian prior to surgery anyways) but I'm still being careful to keep rice bread and the likes out of my diet.

You will gain weight for a couple of weeks. Stored glucose has a water component. If you've been on keto for a while, you'll have depleted your body of normal glucose stores. When you refill those stores with a traditional diet....the glucose is stored with quite a bit of water. Within a couple of weeks, you'll start losing again. But yes...you'll feel that bump. Try not to get discouraged....you're not gaining any fat.

Has anyone ever started out doing keto and then switching back to a more traditional bariatric plan? Did your body adjust easily or did you gain weight? Just to clarify- i don't mean going from keto to eating pizza and french fries all day. But i do mean transitioning from the keto diet to a lower fat, higher protein, low good carb (such as fruits, veggies including starchy veggies and beans) lifestyle.

Keto is low carb (usually less than 30g), moderate protein (bc protein unused turns to sugar, and high fat. The idea is that you starve out of carbs so that your body burns fat for fuel. It works! I recommend Maria emmerich’s website and cookbooks. She explains it well. You have to remember that carbs in non starchy veggies are a little different than refined sugar and bread carbs in that they have fiber.

If cutting carbs and sugar is in your plan there are definitely physical withdrawals. Look up keto flu. Push through the discomfort and know it’s just your body craving those things!

I feel like I know all of the information, I started the process 10 months ago but due to my insurance being so strict I had to attend many classes, seminars, appointments, clearances, over the phone courses, etc. So I feel like the knowledge is there, however from joining this site I am learning new things every day, especially when looking at the post op forums. I know unexpected things will pop up and am prepared for the stalls including the famous 3 week stall and some initial weight gain from water immediately after surgery. Vitamins are something I definitely need to work on. My vitamin D was previously low but I am working on that. Iron is also another issue that I need to be prepared for as I am borderline anemic. I've heard of many post ops being hospitalized and having health issues from not keeping up with their Iron. Working in healthcare I have access to the providers and their knowledge on the subject. One thing with multivitamins is if you overdose on Iron that can be an issue too that can cause issues with your can lead to vomiting, diarrhea, stomach pain, and in extreme cases liver failure. Therefore, I am going to be in constant contact with my provider and request routine blood work on all of my levels. Since we have surgery in April, most of us will be meeting our deductibles and out of pocket max so aside from any copay's we can get as much work done that our insurance deems as medically necessary. This includes blood work and labs on nutrition and vitamin levels. For instance, my deductible is $750 and out of pocket max is $3000. Since my surgery is around $30,000 I met my out of pocket max of $3000 and can get as much work done as I need to for the remainder of the year. Again, copay's still need to be paid for each visit. If I get blood work done by my primary care provider my copay is only $10 compared to the $50 to go to a specialist who will do the same thing. So in general I feel like I am pretty prepared when it comes to the aftercare and communication with my provider's and insurance policies to make sure I can keep in touch with my body to know where I am deficient and what vitamins I will need to increase during the weight loss. I still have a lot to learn about the vitamins. I just cannot get past the taste of chewable vitamins. I tried the Flinstone Chewables my surgeon's office recommended and they are absolutely disgusting with an aftertaste that returns all day. Therefore, I think crushing my pills and putting them in yogurt might be my best option. One tablespoon I do not think will be too hard to get down. I have to take anxiety medication anyways so this won't be too hard I think. In regards to protein, I am currently doing Premier Protein and I am in LOVE!! They recently came out with new flavors such as Oreo & Cream, Peaches & Cream, Caramel, Banana & Cream, along with their traditional of Vanilla, Chocolate, and Strawberries & Cream. The reason I chose this was it has 30 grams of protein in 11oz so even if I cannot consume much in a day, 2 shakes meets my minimum protein for the day and can also double as liquids so will at least give me 22 oz of that. It has 1 gram of sugar per shake, 160 calories, 24 vitamins and nutrients, 5 grams of carbs, and 3 grams of fat, so it works perfect for the traditional Keto Diet. Along with this I will buy myself a rotisserie chicken and slowly pick through that throughout the week. Seems like a pretty cheap diet and I can treat myself to steak every once in a while. My nutritionist wants me to get my protein intake for the day before I move to vegetables, and then carbs which I will rarely be able to ever meet during the weight loss period. After surgery I am prepared for the possibility of not being able to consume Premier Protein anymore. A lot of people say dairy becomes hard to consume after surgery, in which case I think the clear, non dairy Isopure would be a great substitute. Popsicles made from protein drinks also sounds like a fabulous idea. I'd love any other suggestions anyone else may have, and am SUPER excited to get to meet some fellow April Sleever's. I'd love to keep in touch so we can all help each other on our journey!!

I agree. Different eating plans work for different people. Keto is working awesome for elforman and modified Paleo is currently working for me, but your body, especially with the diabetes, may need something entirely different. Your doctor and a nutritionist can really help. We ALL need help through this process.

I've heard such great things about keto but I'm worried about trying it again since I have type 2 diabetes. I'm pre-pre-op in that I have decided I'm interested in surgery but haven't actually started the process with my doc yet. Last time I tried keto I got about 3 weeks in and started having hypoglycemic incidents with low blood sugar, dizziness, and even confusion. I'm not sure how to manage keto and my diabetes medication together.

I really can't look at Keto as I like to work-out and you need more carbs to do that, and I like lots of veggies and fresh fruits which aren't really doable and still keep to the very, very low carb requirements for Keto. I went back to a modified Paleo/Whole 30 diet which focuses on clean food sources, high protein and typically no dairy, grains or legumes and is low sugar (and when you do use sweeteners, only low glycemic sources like real maple syrup, dates or coconut sugar) as this has worked for me in the past. I've never had an issue with eating dairy, grains and legumes in moderation and still loosing weight. So I just don't eat them every day and only in small amounts (like max 1/2 cup serving a day). I make sure any grains I do eat are whole grains or sprouted grains/legumes, and I stick to grass-fed dairy to get the added healthy Omegas. Healthy fat sources are also key for Paleo - like avocados, coconut oil, etc. and keep me from feeling hungry. My surgeon had also recommended the Paleo diet as well. When I'm lazy and don't want to cook, I'm luckily we have a place nearby that makes ready-to-eat Paleo dishes and also makes Paleo compliant condiments like BBQ sauce, steak sauce, etc. which are a pain to make yourself. However, you can now order these things online, and there are meal prep delivery services that follow Paleo/Whole 30 (or Keto) guidelines. The real key for me pre-surgery (and will be for post-surgery) has been learning to avoid office food, planning for office breakfast/lunch meetings and limiting my eating out. This is when I fall off my healthy eating I also have a bad sweet tooth so I've been trying to have alternative choices at work and home like sugar-free jello, stevia flavored gum, real fruit popsicles and fresh fruit. I've been packing my own "snack packs" with things like 1/4c almonds and 1oz of hard cheese or beef jerky and 1/2 cup of seedless grapes or a hard boiled egg and 1/4c cashews. So when the bagels appear, I have something I can reach for 11 pounds down so far. [My case is going before committee this month and I hope to have the surgery in May.] Now I have to gear up my workouts more...

Did the nutritionist lay out a dietary plan for you? Granted, all my nutritionist told me on the first visit was to cut out carbonated beverages and avoid carbs after breakfast. I also had to meet with a dietician at the hospital who basically said I had to meet a certain number of grams of per day pre- and post-surgery, so I took it upon myself to just go full keto. The advantages of doing keto are no calorie counting and little portion measuring, plus with all of the meat, eggs and I cheese I get, I haven't felt hungry in several weeks. So I suggest calling the nutritionist again and asking if he/she has any specific recommendations for you other than "eat less".

Absolutely nothing. That's one of the better parts about doing keto. I was given a daily number of grams of expect protein intake which I know I've exceeded more than a few times. In theory there's a ratio of calorie sources, something like 40% from protein, 50% from fat and 10% from carbs (please don't trust me, look it up), but honestly, I'm not following that. I'm just keeping carbs to a very low level and the rest pretty much takes care of itself. A few times after I felt like I ate too much, even without carbs, I just have four protein shakes the next day. Granted, just because this works for me doesn't mean it'll work for everyone, so please check in with your nutritionist. Meanwhile, congratulations and keep up the good work.

I'm sure there are lots of links and resources that can give you a better overview and explanation of how Keto works and I'd suggest consulting your nutritionist first, but it's not really that hard. My typical weekday is a Kirkland Protein Bar for breakfast (4g net carbs), then a hard boiled egg and piece of string cheese mid-morning. Lunch is a spinach salad with low-carb dressing (like a balsamic vinegar), some raw broccoli (also with the dressing), and a chunk of meat. Mid-afternoon is another egg and another string cheese, then dinner is like lunch but with more meat. My weekends, when I have time to cook, are eggs and bacon in the morning, and the rest of the day is similar except I have a little more variety because I need everything pre-packaged for me at work since I don't have access to a kitchen. There are great desserts such as cheesecake made with cream cheese and splenda or cool whip mixed with peanut butter then frozen. And sometimes if I want something else in place of the egg and cheese I'll have a protein shake like I mentioned in my initial reply. Plus, because the concern is only with net carbs, I found a baking mix like Bisquick called Carb Quick that's almost all fiber. It doesn't taste great in everything, but it satisfies some of the bread craving. I find I don't miss rice or potatoes all that much since I still eat enough to feel full most of the time. You need need to be careful about hidden carbs in things like pasta sauce which may have added sugars. I also found a Weight Watchers "pasta-like" substance that is almost a substitute for the real thing. I don't get obsessive with counting every last gram of carbs, I just know I'm keeping it under 20 a day at worst. One of my problems is that I've been eating so much lean meat that except for eggs and cheese, I'm not getting many calories from fat, they're almost exclusively from protein. That may not be so great either so I'm fortunate my appointment with the nutritionist is tomorrow afternoon and I'll see what she says about that.

See you just gave me something to think about! I've heard about the keto diet, but I don't think I really understand it. How do you keep your carbs so low? I try too, but am still doing like 100-150 carbs a day. I feel like I am missing something in the calculations?

You don't seem to need any advice, you've got this. I'll admit I got lucky in that my nutritionist told me at my first consult for the first month (of three) to just avoid carbs after breakfast, and that was it. I kind of took it upon myself to go full keto, keeping myself under 15g of carbs a day and it's working great, down 23 in two months. Due to what amounts to head-to-toe injuries exercise is not an option for me right now, so I can literally say I'm doing all this without breaking a sweat. I haven't felt hungry a single minute since I started and I'm chomping on a hard boiled egg right now. Like you I have no pre-op liquid diet requirement, so that certainly makes life easier. As for protein shakes, I found a giant barrel of cookies and cream flavored something or other at Costco that I mix with unsweetened almond mile. Search the boards and you'll find lots of recommendations for both powdered and pre-mixed shakes. Good luck with everything.

So I'm two months into my three month pre-op diet (doing keto, no liquid diet required for me pre-op) and weighed myself on the bathroom scale this morning. It read 249.4, which means I can officially express my weight as being less than an eighth of a ton. Getting under 250 wasn't the big deal to me per se, it's that fractional comparison to put the weight in perspective that did it. That's just how my mind works, I think in numbers. Also, I know my bathroom scale is not an accurate reflection of reality. When I see the nutritionist tomorrow afternoon her scale will likely read around 254 as I'll be fully dressed and my cargo pants laden with, well, cargo, but that will still be a drop of 23 in the two months thus far. (BTW, the cargo pants are pretty much a requirement as I screwed up my back pretty good by carrying my wallet in my rear pocket for a couple of decades. Fashion and style be damned.) And speaking of pants, the better part of this morning was realizing I should finally go back into my closet and pull out some older pants that haven't fit well for a year or so. One of the things that made me finally decide to look into surgery was knowing I'd have to keep spending on ever-larger clothes. Part of my decision one day was to stop buying any new clothes at all, which unfortunately left me with just three pairs of pants that fit. It's taken a while, having to do laundry what felt like every other day, but now some of the older ones fit again. Of course, the older ones look identical to my biggest ones because I just bought the same ones online in larger sizes, so nobody is going to notice a thing. Then again, at work everyone knows I'm colorblind so I told them I usually buy multiples of everything that I know will match so I don't have to worry about picking clashing clothes each day. I think they bought that...

Thank you so much for your response. So I did the 6 month process last year and did great. Lost like 40-50lbs and did everything right. Was given a surgery date and didn't follow through. Because of the weight I lost on my own I thought I could do it on my own and didn't want to take the risk at surgery. Well over the last year I gained 15 or so of those pounds back and realized I cant do it all on my own, no matter how good I was eating. So i jumped back on the train to surgery. This go round though i dont know if it's the fear I won't go through again if I lose the weight or that I'm so positive about the surgery I'm scared of not getting to eat the stuff I do now that I'm having a food funeral. I know that I already have a fatty liver so that does scare me and I do want to be in the best shape before surgery. I see a counselor and all though I wanted to keep my surgery somewhat of a secret I think I will talk to her. I'm suppose to be doing the south beach diet. Which for the last year I have been on a diet that has been some what the same as the keto diet, but sense starting back up with the surgery all the progress I made with that diet has gone out the window Sent from my SM-G960U using BariatricPal mobile app

They recommended for me, that I do low carb at 60g of carbs per day, but that was because at the end she didn't want me to lose too much weight and drop below my 35BMI deck. I don't and never did do keto as it's defined today. But honestly, keto is anything that is low enough to get you into fat burning rather than sugar burning. So basically anything below 50-75g for most people. I just never added in the stupid amounts of excess fat the "new" keto adds. Mine was pure Atkins in the original '72 version that said: ONLY protein adequate, only 20g carbs, and eat fat only to make it taste good. Eat ONLY until hunger is assuaged--but not until full. That's vastly different from most people's concept of low carb, which is that it is a protein and fat fest. I absolutely have to watch calories like a hawk! And I have to watch fat too and protein cuz I'm very good at gluconeogenesis. I've only ever eaten around 65-75g of protein daily. That's what my RD wants me eating now. LOL. Ironic right? The idea behind it is because ketosis brings hunger cessation, that you NATURALLY eat fewer calories and thus, lose weight (and you also burn about 400 extra cals/day just converting protein and foods into ketones and a tiny bit of glucose needed to run your body). Congrats on your loss so far! Chances are by doing what you're doing, your liver is gonna be extra pretty!

Did they recommend you do no carbs? I do almost a low carb, but like I said, I blew it this past weekend. I've lost 23lbs during my 6 moth, I still have 2 months left. I still eat some carbs though. I've tried keto and failed at it, I actually gained more weight. I just watch calories.

So look, I'm not gonna lie to you. I worked my ass off pre-op to lose weight and lost somewhere around 50+ lbs if I remember correctly? But along the way, I also had a few food funerals. But for the most part, my diet was very clean. I did this mainly cuz I was terrified that my liver would be as big as a foie gras goose liver! I wanted to reduce it over those 6 months. I truly was so scared I'd be the girl they'd open and close telling me, "Your liver was so damn big, I've never seen anything like it," and close me up without the surgery. So I had surgery about 5weeks ago. The doc told me my liver was small and pink and did just what it was supposed to do--stayed silent and out of the way during my RNY. So the angst is worth it. It's also worth it to decarb, dealcohol, desmoke, and decaffeinate. It's much easier to go through keto flu without the operation to deal with too. My recovery was obscenely easy. The surgery was obscenely easy. Cuz I prepared like hell up front. IF you are truly having eating issues and it sounds like you are, I'd look up a therapist--someone who specializes in bariatrics. I'd ask your surgeon. I would level with your team about what's going on with you and ask for help. My RD was all I needed, but some need more help. Don't be ashamed to do what you need to start your new life out on the right footing!!!

Hey guys! I'm coming up on 3 months next week and feel good! I've been able to tolerate most things. I had a donut today actually and it kinda didn't sit well right after so I won't be doing that again anytime soon. My stats are pretty much accurate still. I stalled for a few days here and there especially when that time of the month sneaks around. I'm on a modified keto/low carb diet for the most part, high protein, at least 120oz of water daily, and 30 mins of cardio. Many people have said I already look "skinny", but I'm not even close to it. Hope you guys love your tool as much as I do!

Okay, I'm confused. (Not uncommon, but I thought I had this one figured out) I had my regularly scheduled meeting with my nurse at the bariatric clinic today. One of the things she commented on is that I'm not eating enough carbs... insert confused emoji here. I'm a type 2 diabetic for five years and had gestational diabetes before then, and somewhere along the way I had been told/read/somehow absorbed the idea that I'm supposed to be eating than less than 100g of carbs (net) per day. My nurse was shocked that I was trying to keep my carbs 'that low'. She wants my carbs to be 50% of my macros. I currently am striving for less than 35%. 50%, which works out to 200g (total) carbs per day on a 1500-1600 calorie diet, just feels like way too much. Am I completely off base? Have I been misinformed all this time? I'm not looking to go keto or Atkins right now, just keeping my carbs low enough to keep my blood sugars controlled and to lose the 10% that my surgeon requires. I don't get to see my nutritionist again until May. Any insight would be appreciated.

Here is a good explanation of the early (three or third week typically) stall: https://www.dsfacts.com/weight-loss-stall-or-plateau.php The term "NUT" is a derogatory term, though many on the forums may not appreciate it, derived from the fact that many on the forums find that their RDs or nutritionists aren't prescribing the latest fad diet that can be found on the internet, so they refer to them as being "nuts" for being so "ignorant" about nutrition ("everybody" "knows" that you gotta do Atkins/Paleo/Keto or whatever is hot today, to lose weight.....) Fundamentally, this initial stall is primarily part of your body adapting to the large caloric deficit that you are imposing upon it, and has little, if anything, to do with what dietary stage you are on - liquids, mushes, softs, etc. as even those of us who started out on soft foods experience it. Also, it would not be unexpected for your loss rate to slow some once things pick up again, as once you get through this initial phase of depleting your glycogen reserves and actually start burning that stored fat, things shift a bit as glycogen (stored carbs, basically) burn faster than fats - approximately 2000 calories per pound for glycogen vs. 3500 calories per pound for fats, so you will be burning more calories to lose a pound from now on. I never had a notable stall at this point, but there was a distinct dogleg in my loss curve at right about three weeks.

Ok, so last week's goal sucked big time... the only thing I accomplished was to keep my carb count down (not Atkins or keto level, but definitely lower for me) and gained 5lbs!!!! How the heck does that happen? (Question: am I the only one who doesn't record the bounces up on my ticker?) Seriously, the only bad thing I ate was some onion rings when the family went to A&W for lunch. I *know* it's water and constipation... my fingers feel like sausages and I'm bloated like crazy. I have an appointment at the bariatric clinic with my nurse tomorrow morning, which I'm not stoked about. I looked for any possible way I could legitimately cancel, but there's just nothing... and really I need to go. My program only allows 3 no-shows/re-scheduled appointments before they kick you to the curb, and I've already had one due to a completely brain dead moment, inputting the wrong time for an appointment on my calendar and I showed up way late. So this week's goals... 1- go to this horrible-no-good weigh-in where I know my nurse is going to give me serious side-eye when I step on the scale. 2 - work out 4 days this week (already did 2!). 3 - keep working on lowering my carbs and upping my protein. Here's to a much better week...

If you're having a hard time doing it on your own, I would recommend enrolling in a medical weight loss program at a local hospital. This is different than just seeing a dietitian or nutritionist once a month. I'm talking about a much more comprehensive program that requires visits at least weekly. I have done this many times. The weight keeps coming back, and that's why I'm here seeking surgery now. But a very low calorie keto diet is relatively easy to sustain when they give you (well you pay for them, of course) the products to consume, track your progress and health along the way, and basically hold your hand all the way through the program. Bottom line: You can do this!

Cyclical, I think you're smart to check out as much research as possible. I do think you're jumping to a lot of conclusions, however. Vomiting isn't necessarily something you'll ever do after surgery. I haven't vomited even once. Haven't experienced any nausea. Have overeaten a couple of times and felt things back up a little. Did a little walking and deep breathing and the sensation went away within a half an hour...and taught me to avoid overeating. While people do typically hit ketosis during the liquid diet phase....you're only talking a couple weeks. You do not have to follow a ketogenic diet post surgery. I sure don't. Some folks do, and do great with it. But there are plenty of surgeons who will work with people who don't want to go the keto route. My diet is similar to Mayo Clinic Diet. Calcium malabsoption could cause dental issues....but again, that's very manageable with monitoring and taking vitamins. My labs at 3 months were all perfect. Good vitamin levels. Perfect sugar. Obviously, results are going to vary and yes, there are risks. But remaining obese is not without serious risk,either. Risk-vs-Benefit...in my opinion....strongly favors having bariatric surgery.