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Yes exactly this. This is so very tiring. Your brain is going a mile a minute and must be burning so many calories. I get B12 shots every 3 months at my doctors. If you have bariatric surgery here it seems to be the norm. These are like liquid energy and I don't need to check my calendar when they are due for renewal. The last two weeks are hell, I drag myself around. I had similar issues to you in my first year. I really struggled to eat and my calories were so low. I tired easily too. My team and I decided that it would be best for me to eat tiny meals, 6 times a day. My menu would be, meal 1, protein yogurt 2, homemade lentil and veg soup 3, scrambled egg 4, Fish in a sauce 5, Some jerky or cheese 6, a latte or some watermelon. This, in my mind gave me everything, I nutritionally needed but my calories were about 500 a day. I started to do full fat everything and upped my calories to 800 slowly. You will feel regret, its a lot to deal with. Every week gets easier. Once you master drinking enough you will leap forward.

Did not get answers that sufficiently addressed my concerns with OCC. Decided to go with Renew Bariatrics and Dr. Rene Armenta. MGB surgery is scheduled for September 2nd. I will report back on experience post surgery.

Hello BariatricPal, I have narrowed my sergeon selection to Dr Ariel Ortiz at OCC, and Dr. Rene Armenta at Renew Bariatrics. I have GERD and require daily medication. I was originally going to get the MGB, until I came across the IGS. Has anyone had the IGS at OCC and is your reflux resolved? Comments appriciated.

In the spring of this year, I changed jobs, moved and finally obtained health insurance that doesn't exclude WLS. After speaking with several co-workers regarding recommendations for a PCP, they almost all suggested that I go to an internationally known teaching hospital. I established myself as a patient of one of the internal medicine specialists and, until today, have been very happy with the coordinated care that I have received. The clinic related to this hospital provides complete care, including labs, diagnostic testing, and specialist care in-house. All of my medical records are available for all of my doctors to review. If my gyn orders bloodwork, the reports are available for my PCP, my bariatric surgeon and my endocrinologist to review. They also have a secure online site that I can access my test results myself. However, today I am wondering if this practice is too bureaucratic and regimented. I have been taking the antidepressant Effexor XR for over 10 years. This drug runs through your system very quickly and causes horrible, awful withdrawal symptoms if a dose is missed. I had my prescription set up with "autofill" with my pharmacy. I don't call in monthly refills; the pharmacy automatically processes refills and notifies me when I need to pick up my medication. Thus, I was not aware that the refills had run out and new script needed to be obtained. Last week, I called the pharmacy to check on the meds and I was told that my doctor needed to authorize a refill and they had contacted their office. They stated that there was nothing I needed to do. On Monday, when I had one dose left, I called the pharmacy and was told the same thing. I panicked a bit because of the short supply of my medication. I was told that my PCP denied the request for a renewal of the script. I determined that the pharmacy called my doctor near my former residence who denied the renewal because I was not currently a patient of his. I told the pharmacy that they needed to contact my current PCP and they informed that they had faxed her also. I also called the PCP department as well. I was told that the refill would be called in within 24 hours. Today, I followed up with the pharmacy, who has not heard from anyone regarding my script. My PCP doc is working the hospital until Friday. She is not responding to her admin assistant's urgent message on my behalf. The pharmist flatly refused to give me a dose or two hold me over. I am dizzy, nauseated, irritable and unable to control my emotions. I am scheduled for an upper endoscopy tomorrow with my WLs surgeon ( the last test before I get a surgery date, insurance is approved. As a last resort, I called the bariatric department to see if my surgeon would call in a small script to hold me over and to enable to me undergo the endoscopy with him tomorrow. If I am shaking, hurting and vomiting, I doubt he will be able to do the endoscope. My request that the surgeon call the script was flatly refused. I was also accused of lying by the patient coordinator on the phone because she didn't see any indication that I had called my PCP more than one time yesterday morning. Apparently my PCP's secretary didn't note the calls in the system. My surgeon's patient coordinator believed their computer over me. At this point I am emotional mess and a physical mess. I don't know what to do. Tomorrow, I don't know if I should try to have the endoscope done or if I should try get an appointment with my former PCP and drive 3 hours to see him. I am worried about what kind of aftercare or emergency care I may receive if I have surgery with this surgeon's practice. I am sure that I am going to change pharmacies and change PCPs. I have never experienced a situation where there wasn't another internist or P.A. available to cover for another. Am I overreacting? Does anyone have any thoughts or suggestions?

Last Chance to Save on Registration for the 2015 Your Weight Matters National Convention! “I had bariatric surgery and I knew I had a second chance at life, so I wanted to do everything I could — even if it meant making myself extremely uncomfortable — to learn enough to be successful.” –Jennifer Coleman, Past Your Weight Matters Convention Attendee No matter where you are on your journey with weight – just getting started and considering all of your options, or several years out from a bariatric surgery – the 2015 Your Weight Matters National Convention offers you the RIGHT education to manage your weight and health. Attendees from across the Nation come together for this 3-day educational event featuring thought leaders in the fields of weight, health, nutrition, exercise and more. We invite you to join in, “Our Journey: Restore. Refresh. Renew.” at the 2015 Your Weight Matters National Convention taking place this August 13-16 in San Antonio! Register NOW for the Best Price! The Obesity Action Coalition (OAC), host of the 2015 Your Weight Matters National Convention, strives to keep the prices affordable for all of our Convention attendees. Registration pricing will increase after June 5, so take advantage of this competitive price, including: $95 for a Full Convention Registration - includes access to all educational sessions, group exercise classes, meals (except for lunch) and tickets to special events. $30 for a One-day Registration – includes access to all educational sessions, group exercise classes and Thursday and Sunday’s special events. Meals are NOT included. After this Friday, June 5, registration pricing options will increase to $125 for a Full Convention Registration or $40 for a One-day Registration. With fun special events, an unsurpassed educational agenda and a welcoming community of attendees, the 2015 Your Weight Matters National Convention gives you the support and resources you need to manage your weight. Early-bird pricing ends on Friday, June 5, so get the savings by CLICKING HERE to register now!

No way of knowing before you do it. Be aware that, as it's the unknown, filling to the max could leave you wishing for death. No bariatric practitioner will do that, certainly not right out of the gate. If you really wish to limit yourself to soft foods and purées for a while, why not just make those your food choices with a reasonable, working level of saline in your band? You'll do as you see fit. I don't know how much good work you've undone, but I'm there, too. In deciding how to get back on the horse, I wouldn't choose a route that might conceivably feel like punishment for having regained weight. That's what a period of soft foods and purées seems to me. The process of eating well and seeing results should be a joy. I don't see a month of mush, for example, as joyful. Best wishes for your renewal regardless of how you do it.

I also have ran into the same problem with United Health Care. I work at a hospital that does the LB and the RNY. However, our insurance has an exclusion. We have appealed to our HR dept with no avail. It seems so unfair that a hospital will do the surgeries but not include them in our policy. We were told in May that it would be included by October. I sat in surgery today watching a RNY be done and was told by the Drs. and the bariatric coordinator that the hospital has decided that it will not be included in October and that so far 60 people have appealed the HR dept. All with no luck. They also stated that it will more then likely not be an inclusion when the insurance is renewed with the next renewal date. So I can feel your pain. If you come up with anything exciting please pass it my way! I will do the same! Good luck to everyone with their insurance endeavors.

No means no. Your employer made the decision to exclude bariatrics--and there's no way around what is stipulated in the contract. You can, however, lobby for a change in policy---if you make enough noise (and point out the costs of NOT providing the care--because obesity tends to cost tons more than WLS)--your company may choose to change their insurance contract when it's time to renew/change. The insurance company will give you what your employer has agreed to pay for. The place to focus your attempts for change is your employer.

the employer can only make changes to their plan off their renewal period if they have made a legal mistake (ie bariatric coverage is required in some states with different conditions per state). Their renewal does not coincide with your plan, so you could speak with the employer and ask them to consider adding this coverage for their next year. (You can also look at your state's legal requirements to be sure they meet the minimum...I've seen many occasions where people don't). We are self insured and this is the sort of thing we like to hear about from our team. Our goal is to provide the best coverage in the business, both as a benefit to our team's well being and for competitive reasons (helps us get the best people). So when we learn that we are lacking in an area from someone we look at how to make that work in our program. When I had my surgery we saw we were lacking in this area and will make the changes for the next period. We did the same for fertility and adoption benefits after seeing we were low. Typically employers go with a plan that is sort of standard, then add bits here and there as necessary. It's impossible to sit there and say "how much do we have for this and that" because it's overwhelming, so we get guided by our administrators. Which is where you come in Yes tell his employer. He may or may not make the change, but it's worth a shot. That said, this probably won't help you during this enrollment period. He can't just add the coverage for you as an appeal.

Hi there: While we don't have a week long retreat we do have a weekend retreat to focus on YOU. We have been doing them for 4 years now and they have been extremely successful. folks leave with comments like I Can Do That!!! Renewed in their commitment to themselves and with a plan to win at the weight loss surgery game. Our next one is coming up April 20-22, 2018 in Portland Oregon and we would love to have you attend. We have had folks from Australia and Canada. Here is a link to the event which we call Spring Into YOU WLS SUCCESS MATTERS SPRING INTO YOU WEEKEND. In addition to that we offer a Back on Track Class via webinar (we use Go to meeting) that meets for 6 weeks on a specified day for about 2 hours. There are books and homework involved in this very thought provoking class and folks have lost regain in that 6 weeks from anywhere between 4 pounds to 24 pounds. Here's a link to the next class coming up. If the time difference doesn't work for you we have done classes at different times of day so let us know what time (US Pacific) would work and we'll see if we can put one together Back On Track Class Finally W e have a Facebook secret group which is 24/7 365 where everyone is working to achieve their goal weight and we (2 bariatric coaches) are in the group facilitating, doing one on one coaching, teaching, motivating and presenting weekly lessons and weekly challenges (focus points). Here's the link to join our next group which begins January 2018 with all of the details THE ORIGINAL WLS SUCCESS MATTERS WEEKLY WEIGH-IN GROUP you can read about us and all we offer at WLS SUCCESS MATTERS BECAUSE YOU MATTER Feel free to ask any questions you might have about any of our programs.

wow. i gotta say looking for a job based only on if they cover lapband is a new one to me. as a small business owner with 9 employees can i give a different viewpoint on this? sorry if it seems crass. i provide pretty decent healthcare insurance for our folks here< at real reasonable rates, but i do not have bariatric coverage included in our pkg. i had lapband by the way in august of this year. i was a self pay. i excluded bariatric coverage because i have 2 employees and 1 of their spouses that would probably utilize it. sounds like a typical "cheap" employers huh? look at it from an employers side. 2 years ago we had 2 gallbladder surgeries and a pregnancy. our renewal rate was initially +24% the following year. my agent got it down to only a 16% increase. we had very few claims last year and no serious ones. latest renewal was less than 1% for 09. good for all of us. if only 1 of these folks had a bariatric operation here in the states it would run minimum of $20k and up to $45k. for 2 folks, double that. here in lies the problem...i know these folks need help but if we have those surgeries go on our insurance our renewal rates would approach 40% to 60% next year IF they choose to renew at all. then what do i do when i can't afford to provide any insurance to ANY of my other empoyees. everyone thinks employers are just greedy and don't want people to be healthy if it costs them money. not true. most small business owners i know want to provide good coverage for their employees but the insurance companies have us by the balls! small companies can't get insurance if there are too many claims on the history so we are forced to be selective where necessary to be able to maintain any coverage. sorry, i'll get off my soapbox now. my advise to you is DO NOT advirtise to potential employers that you want bariatric surgery as soon as you qualify. no one will hire you. trust me on this one. good luck.

So, about this decision I've made to pursue VSG. It wasn't an easy one, and in fact, I went down this road almost 1 year ago. A year ago I was at my highest weight. At 5'3" I weighed 259 lbs. I was so disgusted with myself and was at the end of my rope. I looked into bariatric surgery and was really interested. I exchanged lots of emails with an old friend that was working for one of the best bariatric surgeons in the Atlanta area. I was excited at the prospect of doing this - I knew the benefits greatly outweighed the risks. It seemed I was in pain all the time, I had failed at so many diets, and hunger always won. After talking it over with my husband, we agreed that we should go forward with the process. Well, unfortunately my excitement came to a screeching halt when I found out that my insurance wouldn't cover ANY bariatric procedure. Since the company I work for was a privately owned small business, bariatric surgery was completely excluded from the policy. BAM. Plans Over. So, I joined a gym, and hired a personal trainer. 3 days a week I gave that little fella my blood, sweat and tears. And a little pee, but that's another story entirely lol. I followed a strict Paleo diet and lost about 32 lbs in a matter of 5 months. Then, out of nowhere I had wrenching back pain that made it very difficult to even walk. This went on for weeks, and finally my husband insisted that I see a doctor. Well, guess what? One torn disc, one bulging disk, very bad facet arthropathy (a crap ton of arthritis in my lower back), and spondylosis. Yeah, to put it in a nutshell, I was screwed. Fast forward to July of this year and I began to see a specialist who periodically injected me with steroids in my back which helped tremendously with the pain. Because I did so well with them, he recommended that I have a nerve ablation procedure (now when I say my nerves are fried - they really are!). About a week after that procedure an entirely new pain began. Head to toe agony. More doctors, more specialists. Diagnosis - Fibromyalgia. Often the onset of this ridiculous disease occurs after an invasive procedure. The most unfortunate part about this diagnosis and the one before it is that I'll never again be able to train like I once did. I sank into a deep depression; I honestly felt like life as I knew it was over. I rapidly gained weight back, up to 240.6 now. I tried to stay positive about it, but I literally went from an energetic, do-everything possible in a day kind of person, to an aching, sad, shell of a woman. Fearing that my fate was to forever be fat, my husband, my partner in life had an idea. How did this not occur to me? It's amazing how depression clouds your thinking. His realization about a critical fact was like a ray of light. In January, the small business I worked for was purchased by a huge corporation, and in March... you guessed it... new insurance. One phone call to the number on the back of my card and my hope is renewed. They cover bariatric surgery. My consultation with the surgeon is tomorrow! Wednesday, Oct. 15th. They are saying that I qualify for the "Fast Track" to surgery and I could be sleeved as soon as November or December!!! Send me prayers, love and light. Stay tuned...

Hey BariatricPal Members! Happy Independence Day from BariatricPal! It’s a chance to show off your national pride if you tend to be patriotic. Otherwise, it’s a chance for a three-day weekend, some relaxation, and hopefully some celebrations and family time. And, of course, a chance to keep chasing your weight loss surgery goals. As always, we hope to help, so here’s what you’ll find in this newsletter. Independence Day: Celebrate Your Freedom Taking a Look at Those Summer Goals Red, White, and Blue Bariatric food Ideas Hope you love the newsletter and then take advantage of the long weekend and a little down time to logon to the BariatricPal forums to catch up on all the discussions. Thanks for all of your support, and Happy Independence Day! Sincerely, Alex Brecher Founder, BariatricPal Independence Day: Celebrate Your Freedom July 4 celebrates the freedoms we all cherish. Each of us can do what we wish, and that’s not something to be taken lightly. So as you go through these next few days, why not pay a little extra attention to the choices you are making each and every minute, and remember to be grateful that those choices are in your hands? The Freedom to Eat What You Want It may not be what the Founding Fathers had in mind when they signed the Declaration of Independence, but being free includes being free to eat what you want. So what’ll it be for you? pizza, chips, and a soda? Or tuna, yogurt, and strawberries? Nobody but you has the right to decide, so make the decision that would make the Founding Fathers proud – the decision that will make you the strongest and healthiest citizen possible. Land of Opportunity…and Options What’s another great thing about the freedom we have in this country? How about seeing how easy it is to get your hands on delicious, high-Protein foods? At The BariatricPal Store, you can get high-protein, low-carb meals, Snacks, and beverages for every occasion and every time of day. Our low-carb cereals, pastas, protein bars and protein powders, and instant entrees can be yours with the click of a button. The store promises the lowest prices available online, and we back our products with a satisfaction guarantee. Taking a Look at Those Summer Goals Summer has a habit of slipping away. At the beginning, it seems like it will last forever, with the long days stretching out endlessly. Then all of a sudden, the nights get crisp and autumn arrives before you know it. Don’t let your summer goals slip away with the summer! July 4 is a great time to refocus on those goals – or set them, if you haven’t already. So, here are a few steps you can take to be sure you can look back at Summer 2016 as one that did wonders for your health and weight. Remind yourself – or set – your goals. Keep them realistic, measurable, and under your control. There’s no point in setting a goal that depends on factors outside of your control. Examples of possible goals include getting in five servings of fruits and vegetables a day by summer’s end, walking a September 5k, and getting WLS in the fall. Figure out what you need to do to hit your goals. For example, what kind of diet do you need to follow? Do you need to train a certain way if you have a fitness goal? Do you need more information if your goal is to get surgery? Get working! Make any necessary changes to your diet if your goals are related to weight or eating habits. Write out your workout schedule, and stick to it. Make any phone calls to potential surgeons to gather more information about getting weight loss surgery if that’s your end-of-summer goal. Slow and steady effort is one of the biggest tricks to hitting your goals. Be patient and persistent; love yourself, and be confident that you can do it. With renewed focus and daily commitment, your efforts will add up to big things by the end of summer. Red, White, and Blue Bariatric Food Ideas A festive July 4 picnic or cookout can spell trouble if it involves the usual barbecue fare (slaw, burgers, and baked Beans come to mind) along with berry cheesecake, Cookies and cake decorated like the American flag, and brownies (just because they’re American!). You may already know how to handle a traditional barbecue (chicken breast and veggies, anyone?), but as for the red, white, and blue? There must be a better way to celebrate Old Glory than with fat and sugar! Instead of the high-calorie culprits, you can find weight loss surgery-friendly red, white, and blue food options to stay in the holiday spirit and to stay within your calorie goals. When you choose naturally colored foods, you’re almost sure to end up with nutritious, satisfying, and diet-friendly choices that actually are as Starting the Day Red, White, and Blue Get in the mood from the get-go with a bowl of protein oatmeal, whitened up with a swirl of fat-free ricotta cheese or Greek yogurt. Stir in some sliced strawberries and blueberries, and you’re on your way to a fiber and protein-filled day. The amount of sugar and calories in your breakfast doesn’t even compare to the load you’d get from a stack of pancakes with whipped cream and blueberry and strawberry syrup. Red, White, and Blue Cheese Dip Blue cheese contributes both the blue and the white colors, and it’s easy to add the red. Whip up your favorite blue cheese dip and serve it with red bell pepper strips, or, for a bit of a fancy twist, some baked beet chips. For the non-WLS patients at the party, serve some blue corn chips for an even more festive presentation. Red, White, and Blue Skewers If you’re planning to do a little July 4 grilling, keep it healthy while making it patriotic with red, white, and blue skewers. Use cherry tomatoes or red bell peppers, and add blue from eggplant slices. Then take your pick of white options, from button mushrooms or, for some protein, chicken breast or tofu. Drizzle your kebabs with olive oil and seasonings of your choice. Patriotic Dessert to Live For Granted, it may not be as decadent as a frosted cupcake with a candy flag it in, but a fresh fruit salad can do just as much for your patriotism and far more for your longevity. Watermelon, white nectarines, and fresh blueberries can be just the beginning, with plenty more choices like strawberries, grated coconut, and blackberries waiting in the wings. With these ideas for treats and tricks, have a wonderful and safe Independence Day! Thanks for reading the newsletter and continuing to support BariatricPal. We couldn’t do it without you!

The Latest on Nutrition and hair Loss in the Bariatric Patient by Jacqueline Jacques, ND Nutrition and Hair Loss A common fear and complaint of bariatric surgery patients is postoperative hair loss. While for most of us as people, our hair is important as part of our self-image and body image, it is not very important to our bodies. For this reason, nutrition can have a great impact on hair health because when forced to make a choice, the body will shift nutritional stores to vital organs like the brain and heart and away from hair. Hair loss has many causes. The most common type of hair loss after weight loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes. Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states: anagen, a growth phase, and telogen, a dormant or resting stage. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase,which lasts for approximately 100 to 120 days. Following this, the hair will fall out. Typically, about 90 percent of hairs are anagen and 10 percent are telogen at any give time—meaning that we are usually losing a lot less hair than we are growing, so the hair loss is not noticeable. But sometimes this can change. Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include the following: high fever, severe infection, major surgery, acute physical trauma, chronic debilitating illness (such as cancer or end-stage liver disease), hormonal disruption (such as pregnancy, childbirth, or discontinuation of estrogen therapy), acute weight loss, crash dieting, anorexia, low Protein intake, Iron or zinc deficiency, heavy metal toxicity, and some medications (such as beta-blockers, anticoagulants, retinoids, and immunizations). Nutritional issues aside, bariatric surgery patients already have two major risks of major surgery and rapid weight loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss will rarely last for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back. Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One should be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if any of the following occurred: 1. Hair loss continued more than one year after surgery 2. Hair loss started more than six months after surgery 3. Patient has had difficulty eating and/or has not complied with supplementation 4. Patient has demonstrated low values of ferritin, zinc, or protein 5. Patient has had more rapid than expected weight loss 6. Other symptoms of deficiency are present. Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40mg/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemic, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after biliopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high-dose zinc supplementation as a therapeutic agent for related hair loss2 in patients who had undergone vertical banded gastroplasty. The study administered 200mg of zinc sulfate (45mg elemental zinc) three times daily to postoperative patients with hair loss. This was in addition to the Multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus, we cannot definitively say that zinc would prevent hair loss after weight loss surgery, and further study would definitely be needed to make this connection. A further note: The tolerable upper intake level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60mg/day. Information related to this study has made its way to many a support group and chat room—even to doctor’s offices—with the message that “high-dose zinc will prevent hair loss after weight loss surgery.” Patients should be advised that high-dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen, or prealbumen.3 Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk.4 With surgical reduction of the stomach, hydrochloric acid,5 pepsinogen, and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion rather than malabsorption is responsible for many cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2g of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Biotin Many individuals believe that supplementing with, or topically applying, the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include Vitamin A, inositol, folate, B6, and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS), and is influenced by genetics. Conclusions Hair loss can be distressing to bariatric surgery patients, and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is most likely caused by surgery and rapid weight loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value. References 1. Rushton DH. Clin Exp Dermatol. 2002;27(5):396–404. 2. Neve H, Bhatti W, Soulsby C, et al. Reversal of hair loss following vertical gastroplasty when treated with zinc sulphate. Obes Surg. 199;6(1):63–65. 3. Updegraff TA, Neufeld NJ. Protein, iron, and folate status of patients prior to and following surgery for morbid obesity. J Am Diet Assoc. 1981;78(2):135–140. 4. Segal A, Kinoshita Kussunoki D, Larino MA. Postsurgical refusal to eat: anorexia nervosa, bulimia nervosa or a new eating disorder? A case series. Obes Surg. 2004;14(3):353–360. 5. Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity.Dig Dis Sci. 1994;39(2):315–20. 6. Moize V, Geliebter A, Gluck ME, et al. Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg. 2003;13(1):23–28. 7. Mock DM. Biotin. In: Shils M, Olson JA, Shike M, Ross AC, eds. Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkins; 1999:459–466.

I hope I have found a renewed faith in myself that I finally will make it through. I have found that I matter to others through Bariatric Pal, I was down on ME and about to give up and die FAT when I tremblingly reached out on here, read read others stories, some had come from much worse places in life than me, they had been a success and I started to think "Frusrt8, old but,imaybe just maybe YOU can do this too. I realized many life could still be lived and lived with more joy than I was having. And even now the stories of others inspires me. And in July 2018 my RuN should occur. Scared? Shoot No,I am looking to the days counting on down. Might not be anyone else's journey but it will be mine, and in long run I still do matter so much!😛🏣👍

Last Chance to Save on Registration for the 2015 Your Weight Matters National Convention! “I had bariatric surgery and I knew I had a second chance at life, so I wanted to do everything I could — even if it meant making myself extremely uncomfortable — to learn enough to be successful.” –Jennifer Coleman, Past Your Weight Matters Convention Attendee No matter where you are on your journey with weight – just getting started and considering all of your options, or several years out from a bariatric surgery – the 2015 Your Weight Matters National Convention offers you the RIGHT education to manage your weight and health. Attendees from across the Nation come together for this 3-day educational event featuring thought leaders in the fields of weight, health, nutrition, exercise and more. We invite you to join in, “Our Journey: Restore. Refresh. Renew.” at the 2015 Your Weight Matters National Convention taking place this August 13-16 in San Antonio! Register NOW for the Best Price! The Obesity Action Coalition (OAC), host of the 2015 Your Weight Matters National Convention, strives to keep the prices affordable for all of our Convention attendees. Registration pricing will increase after June 5, so take advantage of this competitive price, including: $95 for a Full Convention Registration - includes access to all educational sessions, group exercise classes, meals (except for lunch) and tickets to special events. $30 for a One-day Registration – includes access to all educational sessions, group exercise classes and Thursday and Sunday’s special events. Meals are NOT included. After this Friday, June 5, registration pricing options will increase to $125 for a Full Convention Registration or $40 for a One-day Registration. With fun special events, an unsurpassed educational agenda and a welcoming community of attendees, the 2015 Your Weight Matters National Convention gives you the support and resources you need to manage your weight. Early-bird pricing ends on Friday, June 5, so get the savings by CLICKING HERE to register now!

Here's my saga. I posted this elsewhere in the forums and was kind of surprised at the negative response, so let me say, this is just my story. I'm not bashing the band, I'm very thankful for the success I had with it. I'm not bitter or angry, it just didn't work for me long term. I had a Realize band placed in February of 2009. My starting weight was 268. The band was fantastic and I lost weight steadily, with the exception of a few months when I realized how easy Cookies were to eat. In December of 2010, I hit the 100 pounds lost mark, I also found out I was pregnant that same week. At about 4 weeks pregnant I had a really nasty 3 day stomach flu. A few days after recovering from that, I started throwing up again. I could keep food down for a few hours, but it was all coming back up. I lost another 15 pounds in 2 weeks. I thought it was just severe morning sickness, even though in 5 previous pregnancies I'd never had morning sickness. I saw my Ob who told me to immediately get my band unfilled and if I was still throwing up the next day he'd have to admit me into the hospital. I got a complete unfill and immediately felt better, but with no restriction and absolutely no mental/physical/spiritual preparedness for no restriction, my love affair with all things bread and pastry renewed like we were never apart. I gained 40 pounds in the first 4 months of my pregnancy. I managed to gain back a little control, but ended up gaining about 60 pounds before I had my daughter in August of 2011. The weight gain took a great emotional toll on me, but I just knew that 6 weeks postpartum I'd get a fill and be right back on track... You know where this is going, right? In October of 2011 I got my band refilled. Pre-pregnancy, my fill level was at 7.2cc in an 11 cc band. We filled it to 3.5 cc and 3 weeks later filled it to 5 cc. I had very little restriction and it just didn't seem right. I'd also started getting heartburn. I went back a few weeks later and we filled it to 5.5. That lasted 24 hours, I had to go back in for an unfill and we went down to 5.2 so I could get Water down. I still didn't have much restriction, but I did have terrible heartburn and vomiting in the middle of the night. I lived with this for a few months until I couldn't stand it and went back in and had .5 cc removed. This made the heartburn manageable with daily meds and tums always at hand, but there was no restriction. I could eat all the bread, Pasta, rice that I wanted. I knew I had a slip, but didn't have insurance to cover bariatrics, so I lived with it. I tried eating less, exercise, weight watchers, even a juice fast but I've gained 20 more pounds on top of the baby weight. Fast forward to now and I finally have insurance to cover bariatrics. I went in a few weeks ago and had my upper GI. It showed a slip above the band, virtually my entire stomach is above the band, which is why there is no restriction felt, but the band was so tight that flow into the rest of my digestive tract was severely restricted. Food just sat there for a really long time, and the results of that we're just kind of gross. We unfilled the band completely to see if the slip would fix itself, although, we all knew what that result would be. The pregnancy hadn't caused the slip, the stomach flu had and 9 months of an empty band hadn't helped it unslip. I got that confirmation this week. My band is still slipped and the restriction is still severe even empty. I'm frustrated, but quite relieved that there has been a real issue this whole time and it wasn't just me. We're now going through the process of getting insurance approval to revise to a sleeve and I couldn't be happier.

I'm not sure if you will get any responses right now about Renew Bariatrics, but if you use the search tool here on BP you can find threads from the past, which might give you some insight about your topic... Best wishes. https://www.bariatricpal.com/search/?q=renew bariatrics

I think I would next send that same email to the gym manager/owner and explain that you haven't hear from the trainer. I'd say I was very hurt by his unprofessional reaction to your statement that you are having a life saving surgery. To say that you are cheating by having the surgery shows that he wants you to fail at weight loss, and feels himself superior (in my opinion). He obviously does not want you to succeed, at the very least, he could use some education about bariatric surgery. No one deserves to be treated the way you were. I know it happens, but it shouldn't. If you had said you were having open heart surgery, he'd have probably said, "I'll be here waiting for you when you are ready to start again!" But darn you that you are trying to avoid that! Ask that you be lined up with a trainer who has worked with bariatric patients before and understands our needs. If the gym doesn't have anyone like that, it would be a great idea for them to invest in someone who does understand the bariatric community. I think I'd tell them I don't plan to renew my personal training sessions when they run out.

My surgery date is 12/2 with Dr. Perez and Renew Bariatrics in Tj, Mexico! So nervous and excited!!

Here's the whole slew of things I'm taking pre-op and supposed to continue post-op (aside the biotin/collage - that's my choice). So far I feel like a million bucks just after a few days! : - Multivitamin capsule (BariatricPal 1xday) - B-100 Complex (NOW brand 1xday) - Vitamin D3 (Zahler brand - 3000iu 1xday) - Calcium Chewy Bites (Bariatric Advantage 3xday) - Biotin (Sports Research 10,000mcg 1xday) - Collagen Peptides (Sports Research 1 packet daily - taken this for 4 months already, makes my hair and nails grow super fast) - 50 billion Probiotic (Renew Life Extra Care) - B12 chewable (Radiance Platinum 5,000mcg)

Hello everyone! I thought it would be helpful to have a detailed account of my experiences from first pre-op meeting through surgery (have a date but have not yet been sleeved) and perhaps beyond. These are my experiences which I think are fairly typical though yours may differ. Much of this same information is available here on bariatric pal but may take a bit more digging than I hope to lay it out here. So, let's begin. May of 2012: I began to seriously consider bariatric surgery and began hunting around for information and resources. It was then that I found Bariatric Pal. I thought my mind was made up about getting the lap band but after reading numerous posts here, I also began to consider gastric sleeve. The band seemed simplest and safest to me. After reading many, many posts here, I learned that that was not only untrue but that the band simply didn't work for most people. June of 2013: I finally got up the courage to see a surgeon about the surgery. After seeing him I was sold on the sleeve. It has a great long term success rate of an acerage of 60-70% (depending on the study) excess weight lost for five years or more. He highly discouraged the band and simply said it just doesn't have the success rate and he is not recommending them. August of 2013: I learned that my insurance at the time would not cover the sleeve, band or any other bariatric surgeries or weight loss programs. I was very upset but renewed my determination to lose weight "on my own". I did. I went from 385 lbs down to 305 and felt like a million bucks. I was absolutely positive I would shrink all the way down to my then goal weight of 225. Hah. Mid 2014: I ballooned back up to about 365/370 and began experiencing extreme knee pain, occasional chest pain, increased sleep apnea and rising blood pressure. My quality of life sucked. December 2014: I had a total right knee replacement. It was horrible. My weight prevented from attending the inpatient rehab clinics that I wanted to attend which had weight restrictions. I wound up in what was essentially an "old folks" convalescent home that made me feel old and invalid. I was ashamed to be there. February 2015: I severely injured my replaced knee while leaving physical therapy. I tore my hamstring and the tendon which attaches to the knee cap. It sucked and I know it was largely due to my weight. The injury still has not healed properly and I continue to feel very handicapped and I am only 48. I can not run at all and standing and walking long distances is out. I again renewed my efforts to lose weight. I went from about 375 to 345 by May and was feeling pretty good. May 2015: I learned I had a diaphragmatic hernia which is like a hiatal hernia but not as close to the esophagus. I had it repaired, which went well but developed an incisional hernia at the site of the laproscopic repair. My efforts at losing weight again turned around. It was at this time that I renewed my intention to get bariatric surgery. I came back to bariatric pal and researched Mexico. July 2015: I was just about set to go to Mexico. I did a skype consultation with Dr Altamirano in TJ and joined his FB group. I began putting the money aside in hopes of going in Mexico for surgery in December. I had strong reservations about Mexico at first but got over it after much reading on here, the consultation and the FB group. Still, I worried about follow up care if there were complications. I had new insurance at work but it still did not cover bariatric surgery. November 2015: I learned from some folks on here that they bought an insurance plan off the Obamacare insurance exchange and used it to cover their surgery right here in the U.S. Some of them even had it as a secondary insurance policy and it worked. My interest was piqued and I began exploring the exchange for an affordable policy that covered bariatric surgery. Some of the others I referred to had success with BC/BS of Illinois and I learned that Illinois requires companies participating in the exchange to cover bariatric surgery. Since I live in Illinois, this was great news! I found a policy that covered the surgery at 100% after a deductible of $3500. Steep but doable. The premium is $398 per month. January 2016: Now we're getting to the meat of the potato. I bought the plan off the exchange, receiving no discount, and it took effect on Feb 1st of 2016. It was the BC/BS IL PPO Silver Plan. Pretty good coverage after deductible. February 2016: I called the insurance company to verify benefits, and they were confirmed. I learned that they did not require a six month diet, or many of the other things that many insurance companies require. They simply said the require a "letter of pre-determination". I also learned that they do not cover the hospital or the surgeon that I initially consulted with. I researched their website and found out that Elmhurst Hospital, and their surgeons were covered. Hallelujah, I live in Elmhurst! I will pick up here later with details of my visits so far!

I’m 62 pounds lighter since my May 28th LAP-BAND® surgery. In eighteen weeks, there has been such significant weight loss and, more relevantly, so much positive change in my health that I can hardly remember the time when I was medically obese and “lost.” First, let’s dispense with the formalities. Need to know exactly what LAP-BAND® surgery involves? Click on The LAP-BAND® I : "Entering the zone" | Babyboomers.tv. Want to know how civilians react to news that I’ve elected to have surgery? Click on http://babyboomers.tv/content/LAP-BAND®-zone-ii-dealing-civilian-response. Interested in hearing about my status and what happens next? Read on. In addition to monthly post-op visits with Dr. Gellman, my bariatric surgeon, -- click on www.northshoresurgical.net -- I’ve lived through 4 months now as a post-operative LAP-BAND® patient. It doesn’t feel that much different than following Weight Watchers, Atkins, and other weight loss programs. Except … I’ve had laparoscopic surgery to help cure my lifelong addiction to food; There is this device inside of me banding the upper portion of my stomach; The LAP-BAND® is a “tool” to help me cut down on food consumption; While my 62-pound weight loss has been sensational, the doctor reminded me this week that the band was inserted for a reason and it’s time to tighten it now. So, this is a different reality for me. The band will be tightened in a few days by injecting saline solution into a port which has been surgically inserted on the inside of my stomach epidermis. The net result is that the band will be tightened and my little stomach pouch (the “stoma”) will feel full with less food. I’ll have to go back on a liquid diet for a few days to allow the stoma to adjust to its new tighter reality. Aside from my regular visits with Dr. Gellman, I also attend a monthly support group with other post-op patients. These groups are enormously helpful for both the camaraderie of those who have been through my same experience as well as for the practical advice I get from participants. At the last group, the topic was “How have you changed for the better or worse following surgery?” I believe life is drastically different (and better) since surgery. However, I’m still a LAP-BAND® rookie so I asked the group “do you all tell people that you’ve had LAP-BAND® surgery?” Interesting responses: “it’s none of anybody’s business”; “nobody has to know”; “they don’t understand”; and, “I only tell my closest friends and relatives”. I understand. Even though I’ve gone public on this website for the entire world to know my story, there are specific people in my life who don’t know about my decision to go through with LAP-BAND® surgery --- most importantly, my mother and father-in-law. They are in their 80’s and they just wouldn’t understand the surgical procedure (or the need for it). Mind you, they are each thrilled to hear about and see my weight loss progress. The best advice to come from the support group, however, has been “If anyone asks how you lost the weight, tell them you’re on Weight Watchers.” This echoes a similar sentiment from Dr Gellman, who reports: “so many of the patients in our practice simply default to “Weight Watchers” when asked how they lost the weight. There is logic here … the final phase of post-operative eating adjustment encompasses a diet that is very much like the Weight Watchers protocol: Eat fruits and vegetables liberally; Follow portion control: 1 ounce of meat = size of a matchbox; 3 ounces of meat = size of a deck of cards; 3 ounces of fish = size of a checkbook; Medium apple = size of a tennis ball. [*]Use little, if any, sugar; [*]Choose lower fat foods; [*]Avoid fried foods; [*]Eat 3 meals a day; [*]Exercise regularly, preferably 3 or 5 or 7 times per week (I walk 4 miles every day;) Who, among us, has not seen this movie before? And yet it really is unlike the thousands of diets I’ve previously been on. I think it has a lot to do with my commitment to a new way of life once I agreed to the surgery. And, I strongly believe in my ability to do this. Also, there is the reality that the little stomach pouch won’t hold the huge quantities of food I had become accustomed to eating. But, if we’re honest, I believe it’s that I don’t want to betray the promise I made to myself: this time, it’s for good and will be different than before. At our tender age when death and illnesses are dodging us, who is gonna argue? I’ve learned from my support group that the post-op fellowship strongly resembles Alcoholics Anonymous: it’s critical to keep sharing your feelings and to report any incident(s) of falling off the wagon. Fine with me, so far. But then, I’ve never really had a problem losing weight --- it’s maintaining my goal weight that has always done me in. For now, I take it one day at a time. The weight loss has been thrilling and I’m extremely grateful for my newfound health and mobility. I’m off blood pressure medicine, I don’t need the sleep apnea machine and my knees have magically stopped hurting during my 3-4 mile daily walks. As for the outside world and how to respond to the queries about “how did you do it?” … I smile like a Cheshire cat and reply that my answer lies in a renewed commitment to exercise and a diet of fruits, vegetables and healthy proteins. I guess my real shorthand answer can be “I’m going to Weight Watchers.”

Thank you for responding! Yes, I was looking into dr Ariel Ortiz at occ. happy you had a positive experience. he has great reviews. a friend had it done with dr cueva at renewal bariatrics. Had a very good experience. When I called them the person I spoke to was much clearer than the person I spoke to at occ. also dr cueva is $2500 less. I would pay if necessary more money, but if I don’t need to why should I the only reviews I found about him were all positive but they were on renewal bariatrics Facebook page. I’m having a hard time making a decision.

Hi all! I will be getting my VSG with Dr Jorge Green at Renew Bariatrics this July. Any past experiences or testimonials from patients would be greatly appreciated