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What post-op diet did your surgeon/nutritionist put you on, and what is your current success/failure result years later?



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Posted (edited)

I had the gastric sleeve performed in July of 2017. The post-op diet consisted of 500 - 600 calories, less than 15 total carbs, and as little fat as possible. This was to be followed until you reached the end goal weight.

My surgeon's goal wait for me was 130 lbs, which is at the higher range of a normal BMI for my 5-ft 1-in height. When I followed that plan I lost weight, but after following it for about a year, it got to be too much like torture, and as soon as I started falling off of the diet, I fell really hard.

I started eating junk food and carbs/snacks every 30 minutes to every 2 hours and I gained all of the weight I lost after surgery back (I'm thankfully still below my highest weight). I've been unable to stick to a diet for longer than 3 days since. So I'm just curious what other surgeons / nutritionists recommended for other patients and whether they are success stories or failure stories, like mine. I'm hoping to model my diet towards the more successful options and see if that is more obtainable in the long run. Thank you all for your responses! Have a great day!

Edited by wordsthatrhyme

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What you are describing...(in my opinion) is a bariatric surgeon who uses his patients as advertisements to get business. People saw you shrink overnight and it made them believers...so now he's got more business.

Here's the problem... No one should ever be on a 600 calorie diet for any long period of time. It's unsustainable, unhealthy, and screws your metabolism to high heaven. It also exacerbates eating disorders and disordered thinking about food...which most of us have. (so says my bariatric therapist, dietician and surgeon)

My surgeon was part of a research project that examined post operative metabolic changes and diet long term. I'm still part of his study and will be ten years out.

We were encouraged to eat 1200 calories a day as soon as possible after surgery. I did this at three weeks post op. We were encouraged to eat lots of protien and few refined carbs. However...unrefined carbs with lots of Fiber were encouraged. I ate oatmeal, potatoes, whole grain toast, nuts, brown rice, etc. The only carbs we actively avoided were sugar, white flour refined stuff, and fruit juice (much better to get it in whole fruit which we were encouraged to eat).

I lost slowly, but I lost to goal. Have been at goal 3 years with the occasional 5 pound backslide...that I promptly address with the bariatric therapist, and lose back to goal. Never takes long...and a little gain is usually a cue that something is stressing me out and I'm regressing to old habits. My program emphasised addressing disordered eating and working on food addiction behavior with new coping behaviors. A bariatric therapist is integral. Don't be without one. Fixing your stomach doesn't fix your head.

I eat 1400-1600 calories a day and maintain well. I walk 10,000+ steps each day and try to get 30 minutes of moderate exercise each day.

I can eat absolutely anything I want now. I do have to plan for indulgent foods and make sure to balance the calories in my day...but after a while, it's getting to be second nature. I eat at events and special occasions and cut back a little for a couple days before or after. It works.

I think my gut bugs have changed (another goal of my program....to change the gut microbiota to resemble the diversity of a healthy weight person). I prefer whole grains, lean protien (lots coming from plant sources), love Beans, mushrooms and potatoes, I shop the produce section more than any other section of the store...love my fruits and veggies. One HUGE change....I pay attention to dietary fiber. I eat at least 25g of Dietary Fiber every day. Most of my fats are plant fats. I do eat meat, but not like most people on here. Meat for me is a special occasion thing, not a staple in my diet. Junk food doesn't taste like it used to. Very honestly. I don't like the taste as much as I used to. If anyone had told me that I would find french fries a turn-off...EVER...I'd have said they were a liar. Loved them. Have no interest in them now....go figure!

Everyone will have a hugely different experience and opinion....and that's ok. People should do what works for them. But my feeling is that my success is down to three things... Learning to balance and be aware of every damned calorie I eat. Eating a high fiber diet with tons of plant protien. Seeing my bariatric therapist PROMPTLY when I know I'm regressing to food addict behavior.

Wishing you the very best. I hope you find a sustainable diet you can tolerate and feel your best eating. Good Luck.

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2 hours ago, wordsthatrhyme said:

I had the gastric sleeve performed in July of 2017. The post-op diet consisted of 500 - 600 calories, less than 15 total carbs, and as little fat as possible. This was to be followed until you reached the end goal weight.

My surgeon's goal wait for me was 130 lbs, which is at the higher range of a normal BMI for my 5-ft 1-in height. When I followed that plan I lost weight, but after following it for about a year, it got to be too much like torture, and as soon as I started falling off of the diet, I fell really hard.

I started eating junk food and carbs/snacks every 30 minutes to every 2 hours and I gained all of the weight I lost after surgery back (I'm thankfully still below my highest weight). I've been unable to stick to a diet for longer than 3 days since. So I'm just curious what other surgeons / nutritionists recommended for other patients and whether they are success stories or failure stories, like mine. I'm hoping to model my diet towards the more successful options and see if that is more obtainable in the long run. Thank you all for your responses! Have a great day!

Forgot to mention that the Protein requirement was 60 - 90 grams per day. Not sure why I can't edit the original post now. :D

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Posted (edited)

I probably ate that little only for the first two or three months. After that it was around 800 cal/day for a few months - and then I was up to around 1000 calories at around 10 months out. I didn't consistently go over 1000 until about the year mark, but WAS consistently over it the second year. Maybe 1000-1200 calories a day. I finally stopped losing weight at 20 months out and gradually increased my calories until I found my sweet spot.

I gained 10 lbs in year 3 (which is very common - and frankly, I needed to - I'd gotten too thin), and then another 10 during the past year (thanks, COVID), which I would like to lose again.

I can maintain if I stay in the 1500-1700 range (that's going to vary for everyone depending on a number of factors).

I never reverted to eating junk. I almost always eat healthy foods - Protein, fruit, vegetables, complex carbs (like whole grains). It's not that I NEVER it junk, but on a regular basis or every day, no. And I have to really monitor what I eat because if I go over my safe range too many times in a week, my weight will start heading north. Like Creekimp, if I have a blow out day one day, I'll cut back for a couple of days so that my week will average out.

your sleeve should still work. to lose the weight again, you'll have to ditch the junk and start eating like we were supposed to be eating again - protein first, then veggies. Small servings of fruit or whole grains are also OK. Figure out how many calories you're eating now by tracking for a few days. Then gradually cut back until you get to a range where you're losing again (gradually cutting is easier for ME, anyway - drastic cuts like 500 calories cut at a pop are tough for me - maybe that's not true of everyone). Losing weight the second time around is much slower, but it CAN be done.

and do find a therapist if you need help with your eating issues. Lots of us have used them and find they help.

Edited by catwoman7

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1 hour ago, Creekimp13 said:

What you are describing...(in my opinion) is a bariatric surgeon who uses his patients as advertisements to get business. People saw you shrink overnight and it made them believers...so now he's got more business.

Here's the problem... No one should ever be on a 600 calorie diet for any long period of time. It's unsustainable, unhealthy, and screws your metabolism to high heaven. It also exacerbates eating disorders and disordered thinking about food...which most of us have. (so says my bariatric therapist, dietician and surgeon)

My surgeon was part of a research project that examined post operative metabolic changes and diet long term. I'm still part of his study and will be ten years out.

We were encouraged to eat 1200 calories a day as soon as possible after surgery. I did this at three weeks post op. We were encouraged to eat lots of protien and few refined carbs. However...unrefined carbs with lots of Fiber were encouraged. I ate oatmeal, potatoes, whole grain toast, nuts, brown rice, etc. The only carbs we actively avoided were sugar, white flour refined stuff, and fruit juice (much better to get it in whole fruit which we were encouraged to eat).

I lost slowly, but I lost to goal. Have been at goal 3 years with the occasional 5 pound backslide...that I promptly address with the bariatric therapist, and lose back to goal. Never takes long...and a little gain is usually a cue that something is stressing me out and I'm regressing to old habits. My program emphasised addressing disordered eating and working on food addiction behavior with new coping behaviors. A bariatric therapist is integral. Don't be without one. Fixing your stomach doesn't fix your head.

I eat 1400-1600 calories a day and maintain well. I walk 10,000+ steps each day and try to get 30 minutes of moderate exercise each day.

I can eat absolutely anything I want now. I do have to plan for indulgent foods and make sure to balance the calories in my day...but after a while, it's getting to be second nature. I eat at events and special occasions and cut back a little for a couple days before or after. It works.

I think my gut bugs have changed (another goal of my program....to change the gut microbiota to resemble the diversity of a healthy weight person). I prefer whole grains, lean protien (lots coming from plant sources), love Beans, mushrooms and potatoes, I shop the produce section more than any other section of the store...love my fruits and veggies. One HUGE change....I pay attention to dietary fiber. I eat at least 25g of Dietary Fiber every day. Most of my fats are plant fats. I do eat meat, but not like most people on here. meat for me is a special occasion thing, not a staple in my diet. Junk food doesn't taste like it used to. Very honestly. I don't like the taste as much as I used to. If anyone had told me that I would find french fries a turn-off...EVER...I'd have said they were a liar. Loved them. Have no interest in them now....go figure!

Everyone will have a hugely different experience and opinion....and that's ok. People should do what works for them. But my feeling is that my success is down to three things... Learning to balance and be aware of every damned calorie I eat. Eating a high fiber diet with tons of plant protien. Seeing my bariatric therapist PROMPTLY when I know I'm regressing to food addict behavior.

Wishing you the very best. I hope you find a sustainable diet you can tolerate and feel your best eating. Good Luck.

Thank you so much for such a detailed response.

I especially appreciate your suggestions for non-animal Protein sources since I will be reaching my 2-year vegan anniversary next month. :)

The 500 calorie diet was torture. I remember just wanting a bite of fruit and being devastated when I was told I needed to continue until I reached goal. (Guess who never made it to goal)

And you're right, I feel like I have a few more eating disorders than I did before the surgery now. I haven't had a diagnosis because I'm a child who's afraid of doctors. This surgery was the most terrifying/bravest thing I've ever done; it was my last straw to losing weight because I'd tried everything else. I got within 15 pounds of goal and gained everything back. It broke my heart.

I'm so excited about the research your surgeon is doing and how that I'm able to see the results when the study is done. It seems like he actually cares about your health and wellbeing.

I love that you're seeing a bariatric therapist;I should probably see you in myself, but I just hate talking about myself. I'll see if I can look into it though.

I wish junk food and taste as good as before. It's I feel like junk food is my main food staple now. All I do is eat sugar and carbs and salties and sweets.

Thank you again so much for such a detailed reply. If you happened to track calories during the weight loss process or even during maintenance, would it be possible to send me a day from your food diary? I'm curious to see how everything was planned out.

P.S. If my reply seems scattered, it's because I'm reading through your message and replying while working with customers at the moment. Sorry about that.

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31 minutes ago, catwoman7 said:

I probably ate that little only for the first two or three months. After that it was around 800 cal/day for a few months - and then I was up to around 1000 calories at around 10 months out. I didn't consistently go over 1000 until about the year mark, but WAS consistently over it the second year. Maybe 1000-1200 calories a day. I finally stopped losing weight at 20 months out and gradually increased my calories until I found my sweet spot.

I gained 10 lbs in year 3 (which is very common - and frankly, I needed to - I'd gotten too thin), and then another 10 during the past year (thanks, COVID), which I would like to lose again.

I can maintain if I stay in the 1500-1700 range (that's going to vary for everyone depending on a number of factors).

I never reverted to eating junk. I almost always eat healthy foods - Protein, fruit, vegetables, complex carbs (like whole grains). It's not that I NEVER it junk, but on a regular basis or every day, no. And I have to really monitor what I eat because if I go over my safe range too many times in a week, my weight will start heading north. Like Creekimp, if I have a blow out day one day, I'll cut back for a couple of days so that my week will average out.

your sleeve should still work. to lose the weight again, you'll have to ditch the junk and start eating like we were supposed to be eating again - Protein first, then veggies. Small servings of fruit or whole grains are also OK. Figure out how many calories you're eating now by tracking for a few days. Then gradually cut back until you get to a range where you're losing again (gradually cutting is easier for ME, anyway - drastic cuts like 500 calories cut at a pop are tough for me - maybe that's not true of everyone). Losing weight the second time around is much slower, but it CAN be done.

and do find a therapist if you need help with your eating issues. Lots of us have used them and find they help.

Thanks for replying as well.

It seems like yout doctor had you eating different ranges gradually to accommodate how small your stomach was but not to restrict you too much. Sounds like a smart, safe plan for someone coming out of surgery.

I love your idea of figuring out how many calories I'm eating now and then reducing by 200 - 500 calories at a time. I think that's a great plan to follow until I can get down to 1,000 to 1,200 calories without feeling like I'm doing too much at once and then binging.

And it's smart that both of you plan for days that you'll be treating yourselves and can accommodate the rest of the days the week so that the average is still cared toward weight loss or maintaining.

I'm so proud of both of you for being able to reach your goals and for maintaining for this long. I'm making notes of all of your suggestions to work out a plan that I can sustainably follow.

Thanks!

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5 hours ago, wordsthatrhyme said:

I love your idea of figuring out how many calories I'm eating now and then reducing by 200 - 500 calories at a time. I think that's a great plan to follow until I can get down to 1,000 to 1,200 calories without feeling like I'm doing too much at once and then binging.

I actually only reduce my calories by about 100 at a time -- once I get kind of used to the new level, i'll drop another 100 calories - and so on. But if you can drop more than that at one time, that's totally fine. I always found I had to be more gradual.

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9 hours ago, wordsthatrhyme said:

I had the gastric sleeve performed in July of 2017. The post-op diet consisted of 500 - 600 calories, less than 15 total carbs, and as little fat as possible. This was to be followed until you reached the end goal weight.

My surgeon's goal wait for me was 130 lbs, which is at the higher range of a normal BMI for my 5-ft 1-in height. When I followed that plan I lost weight, but after following it for about a year, it got to be too much like torture, and as soon as I started falling off of the diet, I fell really hard.

I started eating junk food and carbs/snacks every 30 minutes to every 2 hours and I gained all of the weight I lost after surgery back (I'm thankfully still below my highest weight). I've been unable to stick to a diet for longer than 3 days since. So I'm just curious what other surgeons / nutritionists recommended for other patients and whether they are success stories or failure stories, like mine. I'm hoping to model my diet towards the more successful options and see if that is more obtainable in the long run. Thank you all for your responses! Have a great day!

I'm your same height and my goal was also 130. My surgeon was kind of the polar opposite of yours. He did not give me a calorie target at all. He asked me to keep carbs moderately low (I think it was 60-80g), eat Protein first and then non-starchy veggies. My protein goal was 60g. He encouraged me to eat when hungry, but don't push my restriction. He said if I did that, calories would take care of themselves.

It did work out that way for me. Like a lot of us, I started with very low calories (eating was hard at first). Then I was at 600 for a while and it slowly rose to 800. I stayed there a long time. It took me almost two years to lose all my weight but I did reach (and then pass) my original goal.

I was one of the lucky ones in that I had very little appetite for the first year and when it started to return, it was still much lower than pre-surgery. Even so, the plan you were given seems pretty harsh and I'm not sure I could have stuck to that. 15g of carbs is lower than I can consistently do (and I'm an experienced low-carber!).

Now that I am in maintenance, I do enjoy a treat now and then but day to day, I avoid sugary foods, junk food, fast food, etc. I can't eat that stuff regularly without losing control. I can have a treat, but then it's right back on plan. Otherwise it wakes up cravings that are hard to deal with.

There are lots of less draconian eating plans that most people can lose weight on. I agree with the suggestion to consult a therapist and maybe also find a doctor or nutritionist who is willing to take a more moderate approach. I wish you the best!

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Posted (edited)

Neither my surgeon nor dietician gave me calorie goals to follow while losing. They did recommend 1/4 cup of food from purée stage slowly increasing as I was able to eat more as long as it was low fat, low sugar, low carb. I wasn’t eating 300 calories in that first month. I remember my surgeon drawing a picture of a side plate, then drawing a circle of Protein & a circle of vegetables & saying that’s about how much I’d be eating at goal. He also outlined the size in my palm. He was pretty right.

I was told a daily goal 60g of protein & then slowly add vegetables & fruit to my eating as I progressed. I saw my dietician every two weeks for almost a year (COVID ended it) where we discussed what I had added to my diet & what I thought I’d try next. I can go back to her at anytime.

It took me about a year to find the sweet spot in maintenance & to stop losing. I’m really not active so I maintain my weight through calorie control though I don’t religiously measure & count calories except when I add new foods or do random checks to ensure I’m not slipping.

I keep to about 1200 calories give or take. Awareness of portion size & nutritional value of what I eat are my key considerations. I prepare most of my food so I have control over the ingredients & how it’s cooked. I eat protein (average 60g from meat, seafood & dairy), vegetables, fruit & whole/multi grains (some crackers as a snack & rolled oats). No processed carbs & I avoid as much sugar, sugar substitutes or artificial sweeteners as I possibly can. No fast food in my life & I’ve had takeaway three times since surgery (braised chicken & cashews & skinned steamed gyoza). No carbonated drinks except for tonic, soda or sparkling Water. I don’t allow high sugar or high fat food in my house - if it’s not there I can’t eat it. If I have people over, they take home the leftovers of foods I don’t eat now for the same reason. It may sound restrictive but it’s working for me & I really don’t miss anything.

There are some things I can’t eat or don’t enjoy anymore because my tummy doesn’t tolerate them. I used to eat a lot of avocado but now it tastes off & the texture is strange. Mashed potatoes & Pasta (including plant ones) sit heavily in my tummy & I don’t enjoy alcohol as much. My hunger only came back earlier this year but I still have days I’m not really hungry (like yesterday & today) so I try to eat to routine so I don’t miss meals. If I’m going out for dinner, I’ll drop a snack to allow for what I might eat at the restaurant.

In the past, I wouldn’t weigh myself if I thought I’d put on weight - if I couldn’t see an actual number on the scales I could convince myself I hadn’t gained. So I weigh myself almost every day. I have a fluctuation window of about 1kg (2.2lbs). If it sits on or close to the max for a couple of days in a row, I review my diet & make slight adjustments: drop a snack, reduce a portion size. Sometimes it’s just Fluid or constipation but I find I know my body a lot better now & I make allowances for that.

My medical team would like me to put on a couple of kilos but I’m happy where I am. But who knows what the future will bring. I certainly eat way more frequently than I ever did before surgery and also more than I used to eat: 3 meals & 3-4 Snacks. I think I have a metabolism that is finally working again.

There are so many different eating plans you can follow to lose or maintain. You’ve just got to find what works for you & how you want to live & enjoy your life. Finding a good dietician & therapist who are experienced with bariatric patients is a good place to start.

Good luck finding your path.

Sorry it’s so long.

Edited by Arabesque

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4 hours ago, Jaelzion said:

I'm your same height and my goal was also 130. My surgeon was kind of the polar opposite of yours. He did not give me a calorie target at all. He asked me to keep carbs moderately low (I think it was 60-80g), eat Protein first and then non-starchy veggies. My Protein goal was 60g. He encouraged me to eat when hungry, but don't push my restriction. He said if I did that, calories would take care of themselves.

It did work out that way for me. Like a lot of us, I started with very low calories (eating was hard at first). Then I was at 600 for a while and it slowly rose to 800. I stayed there a long time. It took me almost two years to lose all my weight but I did reach (and then pass) my original goal.

I was one of the lucky ones in that I had very little appetite for the first year and when it started to return, it was still much lower than pre-surgery. Even so, the plan you were given seems pretty harsh and I'm not sure I could have stuck to that. 15g of carbs is lower than I can consistently do (and I'm an experienced low-carber!).

Now that I am in maintenance, I do enjoy a treat now and then but day to day, I avoid sugary foods, junk food, fast food, etc. I can't eat that stuff regularly without losing control. I can have a treat, but then it's right back on plan. Otherwise it wakes up cravings that are hard to deal with.

There are lots of less draconian eating plans that most people can lose weight on. I agree with the suggestion to consult a therapist and maybe also find a doctor or nutritionist who is willing to take a more moderate approach. I wish you the best!

Thanks so much! It's refreshing to see that it can actually be done without such strict rules.

Great job on meeting goal and I'm maintaining it after so long!

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2 hours ago, Arabesque said:

Neither my surgeon nor dietician gave me calorie goals to follow while losing. They did recommend 1/4 cup of food from purée stage slowly increasing as I was able to eat more as long as it was low fat, low sugar, low carb. I wasn’t eating 300 calories in that first month. I remember my surgeon drawing a picture of a side plate, then drawing a circle of Protein & a circle of vegetables & saying that’s about how much I’d be eating at goal. He also outlined the size in my palm. He was pretty right.

I was told a daily goal 60g of Protein & then slowly add vegetables & fruit to my eating as I progressed. I saw my dietician every two weeks for almost a year (COVID ended it) where we discussed what I had added to my diet & what I thought I’d try next. I can go back to her at anytime.

It took me about a year to find the sweet spot in maintenance & to stop losing. I’m really not active so I maintain my weight through calorie control though I don’t religiously measure & count calories except when I add new foods or do random checks to ensure I’m not slipping.

I keep to about 1200 calories give or take. Awareness of portion size & nutritional value of what I eat are my key considerations. I prepare most of my food so I have control over the ingredients & how it’s cooked. I eat protein (average 60g from meat, seafood & dairy), vegetables, fruit & whole/multi grains (some crackers as a snack & rolled oats). No processed carbs & I avoid as much sugar, sugar substitutes or artificial sweeteners as I possibly can. No fast food in my life & I’ve had takeaway three times since surgery (braised chicken & cashews & skinned steamed gyoza). No carbonated drinks except for tonic, soda or sparkling Water. I don’t allow high sugar or high fat food in my house - if it’s not there I can’t eat it. If I have people over, they take home the leftovers of foods I don’t eat now for the same reason. It may sound restrictive but it’s working for me & I really don’t miss anything.

There are some things I can’t eat or don’t enjoy anymore because my tummy doesn’t tolerate them. I used to eat a lot of avocado but now it tastes off & the texture is strange. Mashed potatoes & Pasta (including plant ones) sit heavily in my tummy & I don’t enjoy alcohol as much. My hunger only came back earlier this year but I still have days I’m not really hungry (like yesterday & today) so I try to eat to routine so I don’t miss meals. If I’m going out for dinner, I’ll drop a snack to allow for what I might eat at the restaurant.

In the past, I wouldn’t weigh myself if I thought I’d put on weight - if I couldn’t see an actual number on the scales I could convince myself I hadn’t gained. So I weigh myself almost every day. I have a fluctuation window of about 1kg (2.2lbs). If it sits on or close to the max for a couple of days in a row, I review my diet & make slight adjustments: drop a snack, reduce a portion size. Sometimes it’s just Fluid or constipation but I find I know my body a lot better now & I make allowances for that.

My medical team would like me to put on a couple of kilos but I’m happy where I am. But who knows what the future will bring. I certainly eat way more frequently than I ever did before surgery and also more than I used to eat: 3 meals & 3-4 Snacks. I think I have a metabolism that is finally working again.

There are so many different eating plans you can follow to lose or maintain. You’ve just got to find what works for you & how you want to live & enjoy your life. Finding a good dietician & therapist who are experienced with bariatric patients is a good place to start.

Good luck finding your path.

Sorry it’s so long.

Thank you so much! Great job listening to your hunger cues!

I definitely need to start doing that myself instead of just eating constantly because I want to.

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My initial surgeon put me on a typical post op diet but it included (in my opinion) a high amount of carbohydrate. I lost a significant amount but also dealt with (SOME) regain about 1.5 yrs post op.

I faced an ugly health issue. In response to that I saw another bariatric team that included a GI specialist. They put me on a VERY TIGHT ketogenic regimen and I've stuck to that for 6 years.

I basically eat meat, eggs, green veg, butter/cream, fats and still have a high protein/1 carb shake with Water daily. It's a tight regimen but it reversed the health issue and i lost all my regain.

I honestly believe that most people facing bariatric surgery are significantly insulin resistant (whether diagnosed or not) based on our metabolic profiles. As a nurse practitioner I've done significant research on this topic. I also believe that a very low carb lifestyle is the best fit for most bariatric patients post op, and permanently....this is MY OPINION and NOT MEDICAL ADVICE.

Find what works for you. Maybe seek out another bariatric team. Get some feedback from metabolic specialists. You can do it!

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