I met with my surgeon on Friday for the first time. I settled on the sleeve after discussing it with him. It seems the surgery with the fewest behavior adjustments and the most normal eating. He said that I'm supermorbidly obese at 296 lb. I've always had to watch the calories but it wasn't until my early 40s that the pounds piled on and wouldn't come off. I decided to have bariatric surgery this summer when X-rays showed that I'm bone on bone in my knees and can't have knee replacement surgery until the weight is in a normal range. Dr. Hirai of St. Francis will do my surgery, but he wants me to lose 30 lb before surgery. I want to have the surgery in December, so that doesn't leave me much time to lose it. Is there anyone else who has had to have presurgical dieting and succeeded in getting it off fast. Right now I'm looking at using a protein drink a couple of times a day in place of a meal and cutting out the simple carbs.

For my physician supervised weight loss I went on a low-carb, high Protein diet. I lost 40 lbs pre-op. It makes a lot of sense because our bodies store carbs first in the liver and then everywhere else. So when you strongly limit the carbs your body uses the stores in your liver first, then from the rest of the body and then from your protein. It sucks the first week, but afterwords you generally feel completely normal. I know quite a few people who had to do this and others who didn't but I know that it worked for me. I stayed under 30 g of carbs per day and my protein was close to 100. The trick is to eat protein with every meal and to eat it first. Then eat your veggies.

Good luck!