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I wasn't quite as big as you when I started, but I did start my six month pre-op diet program at 397 pounds. I lost 99 pounds during the six months pre-op (I was so ready to make a change, so I took the plunge into keto eating), and lost the rest of my weight down to goal (180 pounds) at one year and 4 days post-op. That would have been a total of 217 pounds total by one year and 4 days post-op. Here are my questions for you: How many calories do you take in per day? Carbs? Protein? What do you do for exercise? Do you track everything you eat and drink? I ask these questions to maybe get a better picture of your journey. Everyone loses weight at different rates, but when you start off at a higher weight, it usually comes off at a quicker pace if you are doing what you need to do. (But there are SO many factors at play...) I won't even get into the relationship thing in this post. But, I will say this -- everyone deserves to be with someone that loves them for who he or she is, not for who he or she could be...

Hey MominCanada, welcome and thanks for sharing. I had an ESG in November last year in Houston. I checked out Dr. Marvin and was confident in him, you should have a good experience. Stalls, great question, we all have them and there is usually more than one in my experience. It's a large change that our bodies are going though and each body reacts differently, it's not a linear process. I had a stall for 10 days where I didn't lose any weight, gained 1 pound and then afterwards in 2-3 days lost 3 pounds. Difficult for me as an engineer to explain. Water consumption and keeping it high seems to have something to do with it, see several recent posts in ESG forum. A number of us have had stalls, gone back and increased our water intake back >60-80 ounces per day and continued to lose weight. I have a goal >> than 20% weight loss and am about half way there. I would encourage you to discuss your goals clearly with Dr. Marvin and ask his opinion with your specific body size/shape and goal is ESG the best way to go. I had this same discussion with my Dr. and concluded VSG or ESG would work (I did not want something temporary like balloons) and eventually chose ESG due to the simpler procedure and quicker recovery time. My diet is very similar to a ketosis diet (only smaller portions) and when I have my blood checked I am deep into ketosis. Typically eating 2 eggs in AM, 3 ounces of protein at lunch and dinner with 1/4 cup green vegetables and 1/4 cup brown rice or pasta. I will do a yogurt for snack in AM and sugar free chocolate pudding for snack in PM. Total 800-1000 calories/day. When I spoke with the dietician we agreed this was very similar to a keto diet. I have the same approach with sharing, other than my wife not talking about procedure with others. I have told them I'm working with a doctor on a very strict diet, with blood monitoring, etc. Diet is focused on on lean proteins and similar to keto approach. So far so good on that front. Keep the questions coming, we're here to help! Please keep sharing it can help so many others! Tex

I'm 17 months post-op. I lost over 100% of my excess weight, got to my goal at 1 year and 4 days post-op, and have been maintaining almost 10 pounds below goal for over 5 months now. If you eat and drink how you are supposed to eat and drink, you won't regain. I know that a sedentary person at my size (6'0" 173 pounds) needs around 2100 calories per day to maintain his weight; therefore, I keep my calories around 2000 each day. I follow a keto way of eating, so I keep my carbs below 25g per day and my protein around 150g per day. I don't consume sugar, bread, pasta, rice, potatoes, etc. I had to make food fuel in my life and I changed my relationship with food to embrace an eat to live philosophy. I had to do that after having a destructive relationship with food for 40 years. I understand that neither the keto thing nor the eat to live philosophy is for everyone, but the fact remains that if you eat within the proper parameters, you shouldn't regain weight. Frankly having an active, healthy social life beats the hell out of any food and drink any day. I am living my 20s in my 40s and having the time of my life!!

I am 17 months post-op, and still follow a keto way of eating. I have target macros and I keep everything in that range every day (less than 2000 calories, less than 25g of carbs, around 150g of protein). I don't eat sugar, pasta, bread, or rice and I don't drink soda (or really anything carbonated). I have eaten like this throughout my journey, and it is just what I do now. I have made food fuel, and I eat to live only. It has made my life a lot better. I can eat a little bit more at a time now (but I still don't exceed 3oz of dense protein at one sitting), but since I control what I consume so carefully, it hasn't made a difference.

So, it has been a while since I've been active in this community, but I just wanted to share my story and my current struggle with regain. I still feel like having VSG WLS (March 2013) was the best decision of my life. I remember the first year -- the "honeymoon phase" -- when the weight just flew off! It was definitely a major adjustment, having such positive feedback from friends and family. Honestly, I hated the attention I was getting, because I felt like I "cheated" having the procedure. When people asked how I lost the weight, I usually tried to avoid telling them about the surgery, but I'm naturally and honest over-sharer, so I forced the words "weight loss surgery" out of my mouth, and cringed. Nevertheless, I became obsessed with losing weight, and living a healthy lifestyle. Before I knew it, a little over a year later, I had reached my goal weight (140lbs - lowest 135)! I had just turned 20 years old, and I was on top of the world. For the first two years after reaching my goal, maintenance was a breeze. I would gain 3-5 pounds, notice I was snacking a little too much, and correct my actions, and drop the weight. Then, in July 2016, I met a wonderful man and shortly after we moved in together. For the first few months of cohabitation, I went about my normal routine, prepping meals on Sunday for the week, walking every day, and living life as usual. Then came a new "honeymoon phase" of our relationship. Date nights, eating out, spending the weekends in, snacking in front of the TV. I was so happy and in love, that my health and fitness goals went by the wayside. It felt like I blinked and all of a sudden, I had gained 20 pounds in a year. Every time I tried to get back on track, I'd drop 8-10 lbs in a month, and then my SO would insist on indulging in one guilty pleasure or another, and just like that, diet: derailed. One month ago, I stepped on the scale and it read 163lbs, and I said to myself, "Enough is enough!" I had seen a lot of popularity of the ketogenic diet floating around social media, and since it was the only "diet" my SO would agree to try, we went for it together. After a month, I had dropped 6lbs, but I was having tremendous cravings for sweets. Not your typical chocolates and caramels, but I just wanted some fruit! How I longed for a banana... I quickly decided the "keto lifestyle" was not for me. I've since switched my focus to whole foods -- lean meat, whole grains, lots of fruits and veggies and lots of water. I aim for +/-1200 calories a day. I've also joined Beach Body On Demand, and have been religiously "pressing play" on my Insanity workout program. It has only been a week, but since starting, my sleep has improved as well as my mood. Unfortunately, the scale started climbing! Today I weighed in at 158 (+2lbs). I've read a lot of forums that it's probably just water retention, and my muscles trying to repair themselves, but BOY, it is discouraging. I'm worried the gain may be due to an under active thyroid. Regardless, I've made a commitment to myself to press on and finish the 60-day "Insanity Challenge," and see where that leaves me. I decided to revisit this forum, in search of support, and to see if anyone has experienced regain of this magnitude at 3+ years post-op, but I hadn't found much on the topic. So I decided to share a brief summary of my life post-op. Despite the regain, I still consider my VSG story a success. When I think of how far I've come, I realize I'm much closer to my goal weight now than I was before I was sleeved, and that's always a relief. It's time for me to get back to basics and use the tools I've acquired along the way to get me back on track. Weight loss & maintenance is truly a lifelong journey, and there is no "real" finish line.

Probably not. 1 tsp of MOM = 425mg of magnesium (from memory). And if you're already on 100g or less for the last 3 months, it shouldn't be a long trip for you. I'd just keep on keepin on, do your bouillon, and drink your water! Most of the keto flu symptoms are really symptoms of dehydration per the keto docs.

Ok look. I'm not a vet. I can't even pretend to play one on TV or Al Gore's Internet. But I'm 10 days out from surgery and I can say from the SAME FUC*ING DAY of surgery, I have zero, nado, no bueno regrets! It's the best fargin' decision I've ever made. And I'm a foodie/cook/former low carb keto food blogger. It is entirely normal and usual and expected to begin the journey where you are at this precise time. It is normal to experience the grief process. It's normal to second guess. But it's healthy to talk with like-minded people who are knowledgeable about the process/journey/surgery. Your RD and surgical team are GREAT resources, as are the peeps here on BP! I read and researched the hayull outta the surgery and the path toward goal. At your point in time, it is physically IMPOSSIBLE for you to grasp the biochemical change that happens with surgery. It is hard to imagine having a certain ambivalence to food. It is impossible to imagine not being focused on where and what your next meal will consist of! BUT, that's what happens to MANY of us. Not just a few. To MANY of us. I do believe it is SO important to get on board with the "healthy lower carb diet" that your RD promotes. It will probalby look fairly Weight Watchers-ish or Atkins-ish. Glom on and start living the lifestyle NOW at the 6mos out mark. Because it makes the surgery and post surgery transition a low carb piece of cake! Easy peasy lemon squeezy. And I will just say, the fear of never having a "real meal again" is real and expected, but it can also be used as a rationalization for your fat brain to derail your progress and resolution toward surgery. And it's full of crap. For the most part, your post surgical struggle will NOT lay in being unable to eat "crappy" fat-loving meals. It will be in NOT eating that stuff. The operation is on your tummy, but your brain MAY still have desires of its own. You will still have to take control of your thoughts and actions. But your new anatomy will/should facilitate making healthier choices. And as you lose weight quickly, and feel better, you begin to entertain new desires to move more, be healthier, have less focus on food, etc. Hope you will move forward. It's the best decision of my life. I'm sorry I waited so long to dive in and do it!

Hi everyone, I was sleeved 2/8/2018 & today marks 3 weeks post op! Overall i have been feeling pretty good. My only struggle is having a 2 & 3 year old (Who wants me to pick them up) AND a husband who is on the Keto Diet (all meats) lol... STATS SW: 286 CW: 263.2 GW: 175 23 lbs lost so far!

Are you sure you’re getting all your liquids in (64 or more ounces per day)? How many grams of protein are you consuming per day? I had my surgery on 1/2/18. I lost 20 pounds on the pre-op diet (which was almost 3 weeks long). I started out at 229 on 12/15/17 and was 209 on surgery day. Today I weigh 188.4. I had been in a stall for about 2 weeks. I started upping my protein a bit as well as upping the amount of liquids. In addition, I started playing around with keto type foods and I feel that has helped as well. I have only been walking as exercise, usually 2 1/2 miles every other day. I upped that to 3+ miles every other day and the scale started moving again. I have pretty severe degenerative disc disease in my entire spine, so I usually can’t walk every day due to pain. The days I do walk I try to push through the pain. Everyone will lose weight at their own pace. It sounds like you are a lower BMI, so you will likely lose way slower than someone whose BMI is higher. Hang in there......follow your plan and you will eventually start losing again.

Sorry I meant to say make sure you are getting at least 60 g of protein. Protein helps you feel sated so the hunger pangs won't bother you, especially if you go into keto.

Well, I had my one month check-in with the nutritionist today and in just over four weeks I'm down 13 pounds. She'd initially told me to limit my carbs to just the morning except for veggies with lunch and dinner, so I pretty started doing the keto diet on my own and apparently it's working quite well. She told me to just keep doing what I'm doing, come back in a month and by the end of April we'll be ready to schedule the surgery. It's starting to feel real...

I'd like to introduce myself. My name is Charity and I live in a small town in Illinois just across the Mississippi River from St. Louis, MO. My insurance gave me the go ahead, so I'm happy to announce my RNY is scheduled in St. Louis for April 10th ! Being diabetic, my blood sugar has been higher than I'd like of late (all those "last meals") so I am starting the 1400 calorie diet my surgeon wanted me to do prior to surgery, and focusing on cutting out carbs. I've used Keto before to drop weight, so I'll go back to doing what I should have been doing in the first place. HW 396 CW 315 RNY 4/10/2018

That was a typo...I actually lost 36 pounds before surgery. My Bad. I love my group, and I believe in the research they're doing. I did a lot of looking around to find the right folks for me...because I knew I didn't want to do keto diet, and so many bariatric groups ban carbs. (No offense to those who benefit from keto...I know you're out there...it's just not for me) One cool thing about going with a major research hospital is that they serve a very diverse population....there are many patients at my clinic who are vegan, Kosher, Halal...folks from all over the world with all sorts of eating traditions. So, there's a great deal of care and flexibility put into customizing nutrition for each patient. Starvation is a serious factor in stalls. The body has a multitude of evolutionary defense mechanisms in place to protect us from famines, bad hunting seasons, stressful times of healing. There are hormones and enzymes...set point triggers that can save our butts in times of hardship and survival....but wreak havoc on dieting efforts! it's maddening. All of this said....it's very hard to work with a group when you're not following their advice. I don't think discussing variances from the program is ever a bad thing....but ultimately, you need to be working together with common goal with a common philosophy.

I have followed a keto way of eating throughout my journey. I hit my goal of 180 pounds (at 6'0") at 1 year and 4 days post-op (October 2, 2017) and have maintained at 173 pounds for several months now. I still eat keto, keep my carbs below 20-25 per day, and my calories per 2000 per day. I don't eat any differently now than I did when i finished the food stages at 8 weeks post-op (and I am 17 months post-op tomorrow). I changed my relationship with food before I even had the surgery. That has always been the key to my success. My recommendation is to determine what macros will allow you to lose weight and then stick to them every day. Also, determine how much exercise you need to do, and then do it. That's the way to lose weight and then maintain the loss. For me, food has become fuel and the eating process quite scientific. I'm not saying you have to do that, but it was necessary for me to meet my goal and maintain this 225 pound loss.

Keto is when your body goes in Ketosis and burns your fat stores instead of using your food for energy. I eat mostly Meat Dairy and Green Vegetables. I try to keep my daily Carbs under 20 a day.

What’s keto? & thank you(:

It's basically the latest version of the Atkins Diet, i.e. low carb. It's a fad diet, and will eventually fall out of favor. There are some Keto recipes that are high protein and relatively low cal that can fit into a healthy balanced diet. But then there is also the insane part of fad diets, like keto followers having their Starbucks lattes made with heavy cream.

Hello, I was wondering if you have done a little research on eating keto and lowering blood sugars. I really like the Dr. that started Dietdoctor.com. there is great information and videos. To see the videos, you do need to purchase a subscription at 9.00 dollars a month. However, you can do a one month free trial, just put in your phone the date you started, so you can cancel before you are charged. I kept the subscription because I find the videos informative. BTW, you can get the recipes free of charge. He doesn't charge for those. Good luck on your journey. PS. I had to find a Dr. that agreed to this lifestyle . You are eating whole fresh non packaged foods but still some Drs. do not agree. I do drink the bariatric hot chocolate however. It's my sinful pleasure, but low carb. [emoji6] Sent from my SM-G930V using BariatricPal mobile app

I only told two people (in case of emergency) Everyone else appeared too judgemental to me so I decided not telling them was best Other than that when people ask I tell them I eat a lot less and low carb/keto

FYI for those who are unaware: Substituting ground pork rinds for bread crumbs is an acquired taste, to say the least. My wife tried it once when she was doing a keto diet and it was...not my cup of tea.

i am doing the following -weighing every day -tracking everything in myfitnesspal -eating less than 50g carb and NO sugar -moderate protein. around 50-60g -fat to satiety. i don’t count it. -eating only 2 meals a day most days (and a snack that is basically a pickle / piece of cheese) -using intermittent (18:6) fasting and alternate day fasting (basically on one day i eat 2 meals in a 6 or 8 hour window and then when i finish dinner i don’t eat until dinner the next day, then repeat. not counting my morning coffee with heavy whipping cream. i live for it! it works out that i eat one meal a day or two meals a day alternating. only snacks consist of a dill pickles with ounce cheese or tea, coffee or broth in between meals if they are even needed. hunger much less with Low carb healthy fat so not really need much snacking. this sounds hard and the first couple days are but then it becomes normal. i do not do long fasts. those require electrolytes etc and need to be careful if on meds though i am not) i had been grazing and eating carbs to gain the 65lbs over time. i used “never binge again” to give up sugar and my nightly peanut butter sandwich. i also used it to give up snacking. once i got used to 2 meals a day and cut out carbs my hunger and cravings went away. insulin drives cravings and by reducing number of feedings it gets lowered and hunger goes away. this is not for everyone but working for me and for some it is a way to jump start getting back on track. once i get back to my goal i will experiment with how often i need to do the one meal a day thing in order to maintain. i may only need to do it after a party or holiday etc. i am not full keto (that’s under 20g carbs) but essentially that is style i am doing. and intermittent aka “time restricted eating” besides reading jason fung, look him up on youtube. i recommend easing into it gradually over time: -give up sugar then -give up eating after dinner then -give up 1 snack then -give up another snack then -no eating between meals the -give up breakfast (or one meal of your choice) and you don’t even need to go to one meal a day alternatively. the above may already be enough for you. the key is giving your body a break from making insulin. when insulin is secreted your fat cells are told to not burn fat. but read the book, or youtube and do your own research and what works for you.

This is the best quote from the "Low-fat or Low-carb?" article: "On both sides, we heard from people who had lost the most weight that we had helped them change their relationship to food, and that now they were more thoughtful about how they ate." In all of my time participating in BP, that's what I keep saying. There are those on here who don't buy into low carb or keto diets. I get that. But I do take some offense when it is called a fad diet. I have been eating this way for 2 years (since six months pre-op), and it is a key to my success. I have eaten this way with the support of my entire medical team (PCP and bariatric), and my labs continue to be perfect -- absolutely perfect. I am below goal, and have been maintaining for months with ease. That being said, this way of eating isn't for everyone, just like treating food as strictly fuel isn't for everyone. The later was necessary for me, and the former is sustainable for me; that is the key. For me, however one chooses to proceed with this journey, the key to success is making the relationship with food positive and healthy. In so many posts on BP, that continues to be the issue. People treat the surgery (whichever one they choose) as if it's the primary answer when it is merely a supporting player.

Hello my name is Brianna Morris and I will soon be having the Gastric Sleeve Surgery. I went to my new doter and got a referral for the one in the in Texas (where I am from). My highest weight was 323 and my current weight is 299. I have not met my surgeon yet but I am waiting for a call. I am really excited to start becoming a new and better person. My diet right now consists of Keto. Wish me luck

The bickering and outright insults have no place here and are an epic fail for helping anyone. The arguments over various forms of keto, paleo, original Atkins, Atkins 40, Dukan, South Beach, Weight Watchers, etc are never going to end. Many studies trying to prove or disprove them are seriously flawed models with no controls or double blind studies and often with unmeasureable variables. Each person has to eat according to his/her health issues, and body's needs and find livable balance. The medical community can't even agree based on their own research. And weight loss aside there are benefits for lowering insulin levels that are achieved with avoiding simple carbs/limiting carbs. Keto is NOT the same as doing just carb restriction. Each of those 'diets' listed above have their own models they follow and some may be similar. Personally I don't lose if I consume above 80 carbs unless I am extremely active. In Weight Watchers iteration #5,436, I did not lose on the 'free fruit' version if I ate 3 fruits a day. I lost best if my one 'starchy/grain' carb was at the morning meal, one fruit a day, low starch vegetables and protein for all meals, and kept my hard cheese to one ounce a day. VSG is amazing. The physical restriction with the metabolism reset and careful nutrition is the trifecta for me. I am a slower loser at the moment but that does not matter. I am not at the mercy of food cravings.

As much as@johnnycakes overall tone might be a little much, dudes got a point. I have an anecdote that supports the theory he provided. I did the TRUE keto diet before I considered surgery. It was one of the many diets I tried. And I did lose weight... at first. And I did have to eat, what felt to me, like WAY too much fat (heavy cream, coffee with coconut oil and butter, "fat bombs" made from butter, a ridiculous amount of cheese, etc.) in order to meet the daily goals of a true keto diet. Eventually tho, I stopped losing weight, even tho my keto sticks showed I was in ketosis. I measured everything and drank plenty of water. This was not due to human error. I have lost this weight before, on weight watchers and through other programs that incorporate healthy carbohydrates, and even an occasional sweet. I feel like I had the best results eating variety in my diet, and just being sensible with my portions. It's also important for me to track my food. I plan on having slow, steady weight loss with this method. I don't freak out when I hit a stall- they are a part of the process. I'm 7 weeks in and funny enough, when I started eating fruit again, my stall broke. Probably coincidence, but whatever. To each his/her own-- do what works for you! I truly believe everyone's body is different and reacts differently to different things. But I agree that those who are suggesting keto might not be doing a TRUE keto diet, which I hated 100% personally. Sounds more like high protein, low carb, low(ish) fat, which is what my NUT suggests for her clients.