I’m just starting my journey. I’ve been approved by a provider in another state and everything is being done via phone and email pre-surgery. I had my first call with their dietician last week, and she sent me an email which included a diet. I don’t have a surgery date yet - I don’t expect it to be before May. I’ve done my research and was a bit shocked by this. It’s not a pre-op diet, just more of a general diet of 1,600-1,800 calories per day. Part of me feels like - if I could do this at my size, why would I need surgery? Anyone have any thoughts or a similar experience?

I love the way Dr. Now explains this on My 600 Lb. Life - He says that surgery changes how much you can eat in one sitting, but it does not change the things you eat or the frequency of your eating. So if you graze on "bad" foods all day, you can still gain weight even following surgery. Your program likely wants you to start working on establishing those healthy habits early. Also, most programs want you to lose 10% of your excess body weight pre-surgery.

I don't imagine any program expects perfection in this, so I wouldn't stress about it too much. On the other hand, the healthier you are going in for surgery, the better.

most insurance companies require a 3- to 6- month supervised diet like the one you described (some surgeons do as well, but it seems like more often it's the insurance company). A lot of us are required to do this. I found it VERY helpful. It eases the transition between pre- and post-op life so your change in lifestyle after surgery doesn't seem as radical. In mine, I was supposed to limit myself to 2300 calories (I was eating 3000+ before), gradually increase my protein and decrease my carbs, wean myself off carbonation and caffeine, practice separating drinking from eating, exercising 3-5 times a week, etc. I lost 57 lbs in the process and I really think it helped with the transition.

as far as "losing weight with it and therefore not needing surgery" goes, I'd lost 50-60 lbs a gazillion times before - but the problem was, I could never keep it off. I'd hit a wall, bad habits would start to creep back in, I'd stop monitoring myself as closely, and the weight would gradually come back on. With surgery, I've been able to lose ALL my excess weight and keep it off. Plus when you do this on your own, you're constantly fighting biology. Your gut bacteria, hunger hormones, metabolism, etc, are all fighting to put that weight back on. Surgery resets all of that, so even though it's not easy, it's not an impossible battle, either.