So I am six months past surgery. My initial operation was August 21, 2023. I was 328 on the day of, and 376 at my highest before surgery. I lost 20 pounds by 2 weeks after the surgery, and have not lost weight since. I had weighed 305 since then. I noticed my weight creeping up on the scale now, and I'm at 309 again. I will say, however, I have gone from wearing a 4x to wearing a 1x in shirt sizes, though have only gone down two sizes in pants 28 to 24.

I am struggling with drinking water. I feel starving. I've noticed myself wanting to eat every few hours. Then when I eat I vomit, or feel nauseous and spend a good amount of time nearly throwing up. Whenever I drink water I get that pre-vomit spit thing that happens and my mouth just makes spit for like 30 minutes and I feel awful.

I think lack of physical activity has kept me held back in terms of the stagnant weight, I spend most of my days in bed or sitting in a chair at a desk. Is there anything that has helped anyone, any slight tricks to fix me?

I don't want to hide and say I'm doing all the things right I'm doing great anymore, I know I'm not doing the best and I am looking to find support in getting there.

On 2/28/2024 at 7:34 PM, ChunkCat said:

I'm so sorry you are experiencing this!! This isn't a you problem!! If you aren't losing sufficient weight you are either being given poor advice from your nutrition team, poor medical support from your surgeon, or it is possible your body is under significant stress for whatever reason and isn't losing weight. There are rare cases when someone with a sleeve doesn't respond but often those are people who have low starting weights. If they had a high starting weight and don't respond to the sleeve surgery, these people generally end up revised to bypass or a DS/SADI, and then lose weight, but again, that should be a convo being initiated by your surgeon as a future possibility if food modification and medications don't work.

Some people take GLP-1 meds to help jumpstart their weight loss if the surgery hasn't triggered it, but again, at the 6 month mark this should be something the surgeon initiates conversation about. You shouldn't be living in fear of your appointments with them. If you aren't feeling supported you might consider getting a second opinion from another bariatric surgeon in the area not affiliated with this practice. I strongly believe in second opinions when talking things like surgery... It may sound like I'm being harsh on your team, but lets be clear. They made a nice chunk of money off of your surgery. You deserve good aftercare!!

Some surgeons, like my own, believe that the best way to lose weight in the first 6 months to a year after surgery is through being in ketosis. This involves a good Protein intake (60-80 grams with the sleeve) and carbs below 50 total carbs or 30 grams net carbs. You can get pee strips to test if you are in ketosis. Once in ketosis you should go through regular periods when you lose some weight, followed by periods where you lose none as your body stabilizes from the previous loss and recalibrates. If this doesn't happen, I'd definitely be communicating with the surgeon about it! What dietary advice did your team give you?

Hydration is important for weight loss. If you aren't able to eat enough calories or drink enough Water your body will go into starvation mode like @summerseeker mentioned. This is a huge stressor to the body!! And huge stress will cause weight loss to stop. sleep is also crucial to weight loss, often more important than exercise. If you aren't getting regular sleep for enough hours per night, this can stall your weight loss. Physical activity of some kind is important, but it accounts for less weight loss than proper nutrition and sleep. And if you are under calories and under hydrated exercise will just further stress out your body.

Love, love, love this advice!! I can personally tell you that you are 100% correct. I was not drinking enough water (i was relying on Coke Zero) which i know actually dehydrates you. I also got into the bad habit of staying up way too late on my phone while watching Netflix so I was not getting enough sleep. My weigh loss stalled. I have now been drinking a lot more water and making sure i get between 7.5- 8 hours of sleep a night. By doing this i have broken the very long stall/very slow weight loss!! I know this is common knowledge about getting enough water/sleep, I just got into very bad habits for a while. I had my surgery 4/12/23 and have lost 82 lbs so i am doing good, but i knew i could do better!

On 2/29/2024 at 7:49 PM, invisiblyhappy said:

-edit-

I'm stuck in this cycle of feeling hungry, then feeling guilty after I eat because I realize i ate food and I haven't been losing enough weight, then i don't want to eat again for a long time because I want to lose the weight, then i feel starving, then i eat, then i feel guilty, etc etc. It's a really shitty loop I'm stuck in.

If you stop eating food you will not lose weight. If you don't eat enough food you will not lose weight either... If your calories are too low you will drop into starvation mode and your body will lock down and refuse to lose weight as much as possible in order to keep you safe. Stressful events in our lives can cause this to happen too, but it is most commonly caused by not eating enough food.

Your surgeon should have given you a caloric goal along with a sample menu. I think eating protein several times a day is a good sign, chicken and steak are good proteins, as is the yogurt, and most people post op end up using shakes for a while to meet their goals. There is one very big issue with shakes though---they are NOT filling. In fact they will often make you feel hungry.

Looking over your menu for the day what I notice is a distinct lack of fiber. With the exception of the little bits you are getting in the fruit in one of your shakes, you have no fiber. Fiber is very important for fullness and many low carb veggies are very low in calories while being quite voluminous. You are 6 months post op, you should be cleared for all foods, that means veggies of a wide variety. Things you can try that are easier on the tummy: baby spinach (both raw and sauteed), baby bok choy (steamed or sauteed), carrots (raw, steamed, or roasted), cucumber, tomatoes (both raw or cooked), broccoli and cauliflower if they don't make you bloated (both raw and cooked in a myriad of ways), asparagus, summer squash (sauteed or roasted), zuchinni (sauteed or roasted), eggplant (baked), heart of palm noodles, spaghetti squash, and on it goes. Beans are also a good source of fiber while being high in protein too. Well cooked and rinsed beans are a great way to boost volume in your diet! You could also do split peas and lentils. A bean soup would be filling while still being low in calories. At least half your plate per meal and snack should be made up of fruits and vegetables.

Personally, I'd drop the Atkins shake and add vegetables to every meal and snack. Make sure to pair them with protein: hummus with carrot sticks, peanut butter with sliced apples, boiled eggs made into an egg salad and paired with cucumbers, fresh mozzarella with basil, balsamic glaze, and sliced tomatoes, chicken with steamed asparagus, steak with roasted carrots and squash, small salads with protein toppers, yogurt topped with berries and a few spoonfuls of granola. These things will help you feel full and give you a lot of nutrients that you really need right now to feel satisfied. I'd also skip the macaroni for a whole grain or root vegetable if you are craving carbs. So try a side of buckwheat or quinoa, or roasted sweet potatoes, mashed redskin potatoes with the skins on, or roasted pumpkin or butternut squash.

Edited March 8, 20242 yr by ChunkCat

In case this helps, I'll show you what one of my typical days looks like at 4 months post-op. Keep in mind I have had the DS so I eat more. My personal macro goal is 120-150 grams of protein a day, under 50 total carbs, and 100 grams of fat. Also, I can't tolerate any raw fruit at the moment. And calories are not relevant for DS patients because we malabsorb most fat and a good chunk of our protein...

8 am: Premier Protein Cafe Latte Shake

9 am: Ratio Keto Vanilla Yogurt with 2 tablespoons of toasted coconut chips, 1 tablespoon of keto nut granola, and 1 tablespoon freeze dried strawberries

12 noon: 1/4 cup roasted Spaghetti Squash, 1/4 cup of ricotta cheese, 1/4 cup of a beef bolognese sauce

2 pm: Cafe Macchiato with espresso and 4 oz Fairlife Protein Milk

3 pm: 2 mozzarella cheese sticks, 2 mini baby cucumbers and 4 cherry tomatoes

6 pm: Roasted chicken leg and thigh quarter, 1/3 cup of vegetable soup

9 pm: Homemade Keto Banana Walnut Dark Chocolate Muffin

Total Macros: 150 grams of protein (yay!!), 43 grams total carbs, 97 grams of fat, 1634 calories.

On 3/1/2024 at 10:18 AM, NCL04321 said:

Love, love, love this advice!! I can personally tell you that you are 100% correct. I was not drinking enough Water (i was relying on Coke Zero) which i know actually dehydrates you. I also got into the bad habit of staying up way too late on my phone while watching Netflix so I was not getting enough sleep. My weigh loss stalled. I have now been drinking a lot more water and making sure i get between 7.5- 8 hours of sleep a night. By doing this i have broken the very long stall/very slow weight loss!! I know this is common knowledge about getting enough water/sleep, I just got into very bad habits for a while. I had my surgery 4/12/23 and have lost 82 lbs so i am doing good, but i knew i could do better!

I am so excited for you!! Yaaaayyy!! It is really crazy how changing fluids and sleep can make a difference in weight loss! I too notice it immediately on the scale when I slack. It is common knowledge, yes, but so many people brush it off as unimportant when compared to food or exercise. But man, sleep and hydration will undermine your efforts elsewhere if they aren't on point. You are doing an awesome job, pat yourself on the back for changing two habits it would have been easy to ignore!

Since you have difficulty drinking water (I do as well) try things like crystal light frozen, get a icreami and freeze protein shakes or sugar free Jello in liquid form or freeze it. I find the different state of the water makes a huge difference for me. I personally detest plain water and always have (makes me want to vomit) so I've had to come up with ways to get my fluids that work for me:

Sugar free Jello

Frozen or liquid Crystal light

Chicken broth

Soups (yes they count towards water count if made with water)

Protein drinks

I also purchased crystallized lemon and orange powder to add to plain water...it comes in little travel packets.

Good luck, you can do it!

On 2/28/2024 at 7:18 PM, invisiblyhappy said:

So I am six months past surgery. My initial operation was August 21, 2023. I was 328 on the day of, and 376 at my highest before surgery. I lost 20 pounds by 2 weeks after the surgery, and have not lost weight since. I had weighed 305 since then. I noticed my weight creeping up on the scale now, and I'm at 309 again. I will say, however, I have gone from wearing a 4x to wearing a 1x in shirt sizes, though have only gone down two sizes in pants 28 to 24.

I am struggling with drinking Water. I feel starving. I've noticed myself wanting to eat every few hours. Then when I eat I vomit, or feel nauseous and spend a good amount of time nearly throwing up. Whenever I drink water I get that pre-vomit spit thing that happens and my mouth just makes spit for like 30 minutes and I feel awful.

I think lack of physical activity has kept me held back in terms of the stagnant weight, I spend most of my days in bed or sitting in a chair at a desk. Is there anything that has helped anyone, any slight tricks to fix me?

I don't want to hide and say I'm doing all the things right I'm doing great anymore, I know I'm not doing the best and I am looking to find support in getting there.

Have you had any answers about why you’re not losing weight? I have a similar start weight and haven’t lost since two weeks post op as well. I’m nearly two months in so not as far along but I feel like I can eat more than I should be able to so I make sure to count calories but still not losing any weight

2 minutes ago, Andy85 said:

Have you had any answers about why you’re not losing weight? I have a similar start weight and haven’t lost since two weeks post op as well. I’m nearly two months in so not as far along but I feel like I can eat more than I should be able to so I make sure to count calories but still not losing any weight

Kind of yes and no. I met with my surgeon team and was told try to stay around 1000-1200 calories, 130g or less of carbs, and to be at least 80g of protein. They said they don’t know why for some people the metabolism reacts differently and changes greatly with surgery while with others the metabolic response is very minimal. They said obesity is a chronic disease that the body settles into. They said that the journey though is my own and that I shouldn’t be comparing myself to the substantial weight loss others have. I think it’s really hard to not compare sometimes though because many here get the surgery and become very healthy very fast. They are planning to meet with me again in about a month and will discuss various weight loss medicine additions such as ozempic, wegovy, metformin, topiramate, phentermine, mounjaro. It could take one or a pair of these medications together to get the metabolic rate to be where it needs to be for weight loss for me.

9 minutes ago, Andy85 said:

Have you had any answers about why you’re not losing weight? I have a similar start weight and haven’t lost since two weeks post op as well. I’m nearly two months in so not as far along but I feel like I can eat more than I should be able to so I make sure to count calories but still not losing any weight

I also feel like I can eat more than I should be able to. I have heard of others resetting their surgery by following the same post op liquid diet for a week and then soft foods for a few days and then normal again. I haven’t tried it but i am interested in trying it.

Thanks so much for replying. Hopefully those medications will help you! Unfortunately I can’t take any of them at the moment as I’ve been getting low blood sugar. I will have to follow up with my doctors too and see what else I can try

1 minute ago, Andy85 said:

Thanks so much for replying. Hopefully those medications will help you! Unfortunately I can’t take any of them at the moment as I’ve been getting low blood sugar. I will have to follow up with my doctors too and see what else I can try

I get low blood sugar too when I drink enough water it’s frustrating it’s not something) I’ve had to deal with too much and it feels like I’ve just flopped from one end of the problems to the other without getting to reap the weight loss reward. Hopefully your stall breaks and that’s all it is, a stall. I recommend getting a tape measure and doing measurements of yourself at least bc I’ve been losing inches even if the scale is refusing to budge.

I'd like to suggest you try Alkaline water. I had a hard time with water, my surgeon suggested Alkaline water which goes down very smoothly. I also do better adding Crystal Light or any other sugar free flavoring. I now also drink Purified water with no problem. I can't tolerate Spring water. Good luck to you on your journey! Side note, I lost inches first, the number on the scale has been moving very slow. ?

5 hours ago, invisiblyhappy said:

Kind of yes and no. I met with my surgeon team and was told try to stay around 1000-1200 calories, 130g or less of carbs, and to be at least 80g of Protein. They said they don’t know why for some people the metabolism reacts differently and changes greatly with surgery while with others the metabolic response is very minimal. They said obesity is a chronic disease that the body settles into. They said that the journey though is my own and that I shouldn’t be comparing myself to the substantial weight loss others have. I think it’s really hard to not compare sometimes though because many here get the surgery and become very healthy very fast. They are planning to meet with me again in about a month and will discuss various weight loss medicine additions such as Ozempic, Wegovy, metformin, topiramate, phentermine, Mounjaro. It could take one or a pair of these medications together to get the metabolic rate to be where it needs to be for weight loss for me.

I am so glad that you are still reaching out to your team and posting here. I won’t get too far into my story but because of “confusion,” about my mental health, interactions with meds and embarrassment the help I got from my team was not working for me and I gave up. I continued to gain and now I am back here facing revision weighing a little more than when I started this journey. People here are very helpful and understanding but your team should be giving you answers too. Sounds like they have a plan for the next step if need be and that’s great.

if all else fails, The phentermine is the one medication that I could try which did work amazing during the day for me but I suffer from insomnia and when I can’t sleep I eat. So, the meds worked wonderfully during the day but at night, with my larger sleeve and being awake so many times, I was able to consume too much for the whole day and I still gained. But I can see how if you sleep throughout the night it really could work.

I didn’t get to try mountjourno or any of the other brands it’s sold under because of financial reasons but if you can swing it, I have heard AMAZING things about that medicine too (there are some side effects for some people to consider). People claim they think they must know how skinny brains feel after taking it. They just don’t ever have to think or worry about food. One lady has to set alarms if she is busy to remind herself to eat something. Another drawback is how long you have to take it. Some say when you go off it you start to gain. They are doing studies now where they are trying to work out a maintenance dose that may be less than the regular dosage though.

There are also places that are starting to “compound” it at compounding pharmacies. I wouldn’t necessarily trust the stuff from random sites online but my PCP was telling me they were working on getting it in their office and it is less than half the normal cost that way. I don’t know much about the other weight loss drug options because I couldn’t take them with my bipolar meds

Interestingly, i just seen an ABC special Oprah did on weight loss injections the other night. (Ironically it was the day I went back to see my surgeon so I thought maybe it was meant to be which is why I inquired about them with my PCP). I’m really hoping that reached someone that has the power to change how accessible these meds are. I asked my pcp and she said it’s probably going to take a little while like everything else and she thinks at this point I shouldn’t wait on surgery for that but if your interested keep asking questions because these things tend to just change in the middle of the night and the word takes a while to reach you if you not the one asking.

Anywahs, kudos to you for not giving up. Let your team do all they can to help you and keep posting here!!. I think when I stopped that I lost all hope. I was so isolated. Surrounded by skinny family and having only one heavyset friend who is perfectly content being that way I don’t have a lot of real life people who understand me the way that this community does. I felt so ashamed and I didn’t want to drag down the vibe here with my failures. Since I have returned I have been welcomed with open arms and honestly don’t know why I ever doubted that I would be. Keep doing what your doing and you will work this out. I know it. ?

19 hours ago, invisiblyhappy said:

I also feel like I can eat more than I should be able to. I have heard of others resetting their surgery by following the same post op liquid diet for a week and then soft foods for a few days and then normal again. I haven’t tried it but i am interested in trying it.

The pouch reset diet is an old wives tale. You can’t ‘reset’ your pouch. You can only reset your head & thinking. If you think you are eating more than you should, watch your portion sizes carefully & your frequency of meals. Portion control will always be something we have to take care with because as the months pass we are physically able to eat more. Our restriction eases. Our tummy, while still small softens & is more pliable. And our hunger returns. We can also learn how to eat around our smaller tummy.

I was told to eat about a cup at 6 months but as your surgeon said everyone’s journey is different and you may have different needs in regard to how much, what & when you eat. Check with your dietician for the best portion size of proteins, vegetables, etc. & frequency of meals for you. Then you just have to keep to those recommendations. As I always say, all because you can (in this case eat more) doesn’t mean you should.

I’m glad your surgeon is so supportive & is willing to look at other ways of helping you to lose more weight & get closer to where you want to be.

Iam one year on March 31, i was261 on surgery day and one year later I'm 221.so I feel how you are feeling. I feel like i never even had the rny..nothing bothers me i can eat anything i have never had foamies,vomitted,or had the dumping.i drink more than the daily recommendations of water.i exercise 30 mintues 3 times a week and i have been th ame weight since last september.i hmave not gained any nor have i lost any.At my one year check up the dr did a fluoroscopy,she state my pouch was right how its supposed to be.my labs are all on point.so iam i done with losing any more weight? its so frustrating. oh yes get my 60 to 80 grams of protien in.i dont know what iam doing wrong.

4 hours ago, hildajaneb2 said:

Iam one year on March 31, i was261 on surgery day and one year later I'm 221.so I feel how you are feeling. I feel like i never even had the rny..nothing bothers me i can eat anything i have never had foamies,vomitted,or had the dumping.i drink more than the daily recommendations of water.i exercise 30 mintues 3 times a week and i have been th ame weight since last september.i hmave not gained any nor have i lost any.At my one year check up the dr did a fluoroscopy,she state my pouch was right how its supposed to be.my labs are all on point.so iam i done with losing any more weight? its so frustrating. oh yes get my 60 to 80 grams of protien in.i dont know what iam doing wrong.

It’s so frustrating i wonder if for me something else is holding me back like pcos, I’ve had it my whole life. Im also curious if having the drastic weight loss pre surgery affected post surgery and has made it less significant. I’m just as lost and confused here but we’re lost and confused together! Have you tried asking about phentermine or another medication? Pre surgery mounjaro and phentermine really worked well for me.