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Nutritional counseling



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What exactly is the 3-6 month nutritional counseling phase? What exactly is the point of it? Are they trying to see if you can lose weight on your own? Or are they trying to see if you have the ability to follow a program since you will have to after surgery? Just wondering. I have not met with anybody yet about surgery. My appointment with my PCM is on September 6th.

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I am 3 years post-op RNY gastric bypass surgery. I underwent a 6 month diet and exercise program in order to qualify for the surgery. This is a requirement dictated by my health insurance company. The answers to your question are Yes and Yes.

Are they trying to see if you can lose weight on your own? Or are they trying to see if you have the ability to follow a program since you will have to after surgery?

In the past some individuals had surgery, lost weight and gained it all back. Others did not lose any weight at all. Many times this can be attributed to individuals ignoring the surgery plan guidelines.

During the 6 months I kept a food journal. I began reading food labels and caloric breakdown at restaurants that I ate at. I attended bariatric surgery support group meetings. I walked 30 minutes each and every day. I gave up my 6 diet Coke a day habit (no caffeine/no carbonated beverages). I lost 20 pounds.

Another reason why weight loss is important prior to surgery, is to give the surgeon some room to operate in. When I was obese, everything was packed in there very tight. This gave him some operating room to work with.

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Nutrition is a HUGE part of post-op and will be for the rest of your life. You will be amazed at how little you will eat post-op. The little food you eat needs to be well balanced. It will also be critical to follow your supplement regiment (Iron, Calcium, multi and B12). I'm 17 weeks post op and became deficient in Vitamin D and Iron. I began taking Vitamin D and doubled my iron. I'm feeling much better (energy wise).

My nurse told me the liquid diet one week prior to surgery is to allow your liver to shrink. I have a fatty liver so my surgeon ordered a liver scan. He also looked at liver during procedure. The "fat" from liver will go away while I loose weight.

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I'm a bit more cynical. I had to do a 6 month supervised diet program, that was mandatory from my insurance. I ignored it and even gained weight +7lbs until the pre op diet.

Personally I suspect the supervised diet is meant to dissuade people seeking the surgery. 6 months is a big commitment and I have met people who dropped out bc of it. My insurance is bad ass and covered 90% of the cost, but if they discourage people from following through with the surgery, then more profit for them.

sleeved on 08/09 day of surgery- 268 lbs

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I felt like my six month diet helped me wrap my brain around this process. I've read a lot of posts in the past year and researched a ton but I felt like that time was really preparing me for life after surgery. Some programs really want to focus on successful outcomes. I know a few surgeons who build their practice on making sure that this is a lifelong treatment for obesity not just another weight loss scheme. These surgeries are tough and being prepared mentally is important.

During my preop time I would sometimes wish I didn't have to do the six months but post surgery I realize that it gave me time to be full prepared for the lifestyle change.

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Having to have the 6 month nutrition class really helped me to understand the whole process. It is truly alot of information. After your procedure, It will all kick in and plus you will have all the info to go back and read over. My book stays open

Edited by Mudgy6

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What exactly is the 3-6 month nutritional counseling phase? What exactly is the point of it? Are they trying to see if you can lose weight on your own? Or are they trying to see if you have the ability to follow a program since you will have to after surgery? Just wondering. I have not met with anybody yet about surgery. My appointment with my PCM is on September 6th.

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Hi NOVAMOM348,

I'm so glad you asked that question because I was wondering the same thing. I've been reading different posts in the forum for a few days now, but this is my first time posting. I have my first supervised weight loss class this coming Thursday, and even though I know the topic will be Vitamins, I'm not sure what to expect. After 2 years, I was able to get my Dr. to recommend bariatric surgery, and I couldn't be more excited, but it seems like such a long wait, when at the end I'm not even sure if my insurance will approve it. This forum has helped me so much, just reading the stories and experiences, and I look forward to making some new friends on my journey to a new live.

Sent from my VS985 4G using the BariatricPal App

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It's a step the insurance puts in place - I think 6 months is too long (and insurance hopes you'll give up) but found some sessions helpful if you have a good Nutritionist. If they provide you with assistance and guidance as to how you will be eating post-op - it's worth it. I actually found therapy to help more though. Ask ahead of time what the outcome needs to be - some insurances have weight loss requirements, others want to see failure, and others just want you to go through the motions. It sounds like you will be going through specific topics which is good. Just ask questions and keep notes!

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Really the centers use the time to prep you for everything to come. They get you going with Vitamins, smoking cessation (which I needed), time for all appointment like psych evaluation, blood work and any other needed testing. Each visit they set 3 goals for me and it has actually been helping. I was pissed that I had to do it at first, but now I'm just grateful for the time to get everything together- it seriously flies by.

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

      2. Doughgurl

        Thank you so much for your well wishes. I am hoping that everything goes easy for me as well. We don't eat out much as it is, so it wont be too bad in that department. Thankfully. Also, I hear you regarding your back and feet!! I'd like to add knees to the list. Killing me as we speak! I'm only 5' so the weight has to go. Too short to carry all this weight. Menopause really did a doosey on me. (😶lol) My daughter also lives in Houston. with her Husband and my 5 grand-littles. I grew up in Beaumont, so I know Houston well, I will be sure to keep in touch and update you on my journey. I may need some advice in the future, or just motivation. Thank You so much for reaching out, I was hoping to connect with someone in the community. I really appreciate it. 💜

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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