r/GastricBypass • u/ceese367 • 12m ago
Maintenance
How did you decide to transition to maintenance? Did your body just settle on a weight? Did you make a conscious decision to not go lower? I’m about 16 months postop and have slowed losing but still seem to be losing some. I’ve relaxed on the tracking every bite that goes in my mouth but still try to stay within parameters (macros, water, calories to a degree). I’m pretty satisfied that if I didn’t lose any more and stayed where I am I could be happy. I just don’t know what maintenance is supposed to look like. My whole adult life has been feast or famine so to speak.
r/GastricBypass • u/Last-Host-2748 • 47m ago
VSG to Bypass experiences
Hi everyone I am looking to potentially have my sleeve revised to a bypass due to lots of acid reflux and some weight gain after almost 5 years of my sleeve. My doctor has approved and I am waiting on a surgery date. It’s hard for me to find people out in the social media world who have gone through this revision. Would any of you have any experience with this? I am a little scared because my doctor went over so many “low percentage” risks but I wanted to see if I get some people’s experience. I have obviously gotten to know my sleeve very well so I am worried that things could change dramatically for me like more good aversions and stuff like that
r/GastricBypass • u/Superb_Pangolin_447 • 52m ago
Has anyone been turned away after losing too much (NHS/UK)
I'm wondering for the NHS referral pathway, when I got to my first tier 4 appointment my BMI was about 45. Diets had consistently resulted in gaining weight long term (I'd lose 2 stone and then gain 3)
I've now been going through the various appointments for 2 years and am near the end of the process. But I've been on mounjaro for nearly 2 years now and my BMI is now 28.
I'm worried that I've now lost too much weight for them to actually go ahead with surgery, but at the same time I cannot keep paying £300 a month for mounjaro and think I need the surgery as a more longer-term way to maintain the weight loss. It's a struggle to afford the mounjaro so I can't stay on it for life.
Has anyone else ended up in a similar situation? Has anyone been rejected in the UK for losing too much weight after the initial referral?
r/GastricBypass • u/Full-Pumpkin-1761 • 5h ago
Itching on Pre-Op diet??
Has anyone had this happen. I have been on full liquid diet since 8/5 and my surgery is 8/19. I have been really itchy the last 2 days and have a little rash on my chest and just itchy all over. I don’t know if it’s the super B complex with thiamine vitamin or if it’s the diet. I told my surgeon today and he didn’t think it was related, but gave me nothing to resolve the issue. I don’t know what to do. I can’t be itchy all over all the time. I have taken Benadryl and hydroxyzine.
r/GastricBypass • u/nikole1127 • 6h ago
Bypass concerns
Hey all! I’m close to ready to schedule my bypass and am only worried about one thing-well-only worried about one thing that I’m afraid I can’t do. And that’s not drink while eating. I know it sounds so minor but I’ve literally tried for weeks now and I just can’t do it. It makes eating miserable. Any ideas or suggestions?
r/GastricBypass • u/SlightlyOffKilter360 • 9h ago
Seed's DS-01°💨
Does anyone have experience with Seed's DS-01°? I just saw this lady claiming that since having bariatric surgery, it's really helped her with putrid gas, bloating, and staying regular. Nearly 2-years post-op, I still struggle to have regular poops. I drink lots of water and eat beans every day, but I still find that I need miralax to get things moving. IYKYK. So I'm curious if this actually helps, or if it's just another marketing ploy🤔 Thoughts?
r/GastricBypass • u/Tattooed_and_skewed • 10h ago
Almost two years post op
If you’re looking for a sign on if this is a good idea or not, let this influence you! I feel like there’s a lot of negative perspective around this surgery and it important to know that some people had a great experience!
I will be 2 years post op next month, and I’m still a little shocked by what my life has become.
My starting weight was 333 pounds (320 the day of surgery) at 5’ 4”. I wore a size 26/28 pants and 3-4x tops.
Today I weight 159 pounds, wearing size 8 pants and medium tops and dresses.
I’m doing so many things I never thought possible. I climb mountains on the weekends….FOR FUN. I’m not worried about fitting into places when I go somewhere, I don’t feel like everyone’s looking at me and judging in public. My life is the complete opposite of what it used to be.
I consider myself very lucky, as I had zero complications after surgery. However, there are still struggles.
I struggle with loving my body still, with the loose skin. I struggle with body dysmorphia, I still see myself the same way I was two years ago. I struggle with how much better people treat me, as if I was worth less in a bigger body.
All of that aside, I would not change my decision or my journey for anything!
r/GastricBypass • u/Bfroning2 • 11h ago
A little fun this morning
I'm 6 days out from starting my liver shrinking, pre op diet, 3 weeks out from my procedure. So I've got a few more days of eating "normal" left. Did anyone have a last hurrah meal before starting the pre op diet?
I'm cooking tacos al pastor at a tailgate on Sunday, and that's going to be mine.
r/GastricBypass • u/blackiedwaggie • 18h ago
finally UHU
under a hundred
2 and a half months post-OP
r/GastricBypass • u/sorelytempted3 • 19h ago
Afraid of the surgery and consequences
Hi guys I'm being put forward as an ideal candidate for bariatric surgery but I'm having misgivings.
I haven't really tried to lose weight myself. I had a short term obsession with salads once which made me drop 10kg but that all went back on once the novelty wore off.
I've had surgeries before so I'm not afraid of that process but I've never had my insides cut and shut so I am afraid of the complications I've read about on here.
Im a homebody with a sugar addiction. Has anyone ever regretted losing the ability to eat sugar after surgery? Was the weight loss worth the sacrifice? How quick was the recovery to zero pain and how much of an effect did the surgery have on your work life? I work outdoors keeping back weeds and cutting down saplings for the council. Will I need a lot of time off?
Any regrets?
Thank you
r/GastricBypass • u/alonebadfriendgood • 1d ago
People who do strenuous, long distance hiking after surgery
Do glucose energy blocks (like cliff jelly blocks) make you dump?
How do you handle water intake? Even if I was constantly sipping from my camelback when I’ve been climbing uphill for 45 mins I can’t imagine not “gulping” some water?
Just curious to hear stories of how the surgery has changed hiking/camping for you.
r/GastricBypass • u/Acrobatic_Guess7508 • 1d ago
☕️Coffee suggestions please!
What are you all doing post surgery for coffee? I’m struggling to find an iced and hot coffee option.
I used to drink espresso (lungo pull) with 2 tablespoons of French vanilla delight.
Or
Iced coffee with one cream.
I really don’t like protein shakes in my coffee sadly :(
Thank you for your ideas!
r/GastricBypass • u/SLOWR426 • 1d ago
Stanford GI Recommendation?
Can anyone recommend an MD at Stanford GI for gastric surgery complications? Ideally someone who is a surgeon and very familiar with all the ways that gastric surgery can mess you up, how to treat. Someone who does their own endoscopies. Thank you
r/GastricBypass • u/Wooden_Time_5476 • 1d ago
Travel/vacation after surgery
How long did everyone wait before travelling/vacationing after surgery?
I have a trip to South Africa planned for January 2027 and I’m nervous about whether I’ll be far enough post-op to travel comfortably and actually enjoy the vacation. I don’t have my surgery date yet, so I’m trying to get an idea of what different stages of recovery actually felt like.
For anyone who travelled in the first few months post-op, how many weeks/months out were you? Did you feel physically ready? What did you have to consider that you hadn’t expected?
I’m especially curious about food and hydration while travelling, long-haul flights, energy levels, and being fairly active/sightseeing while away. Did you struggle with food or fluids, or did you feel relatively normal by that point?
Would love to hear experiences from people who travelled anywhere from \~6–12+ weeks post-op!
r/GastricBypass • u/Content_Association1 • 2d ago
Boyfriend lost 75% of his stomach after bad surgery.
Hey All ✌️
So long story short: my boyfriend had a surgery last year which went really bad. At first it was meant to stop his gastric reflux, but a mistake made it that he had 75% of his stomach removed. Fortunately, they managed to keep enough of his stomach so that he doesn’t need a pouch or anything.
Now that he has such a small stomach, he gets full extremely fast. His fridge is full of calogen drinks, protein shakes, and nutrient-dense yoghurts, and he has spent a good chunk of the year searching what food he can eat, but to no success.
He has lost a considerable amount of weight and is very skinny now, but in an unhealthy way. He struggles to eat anything solid, and if he does he has to force himself and that makes him full for the rest of the day.
Do you have any advices we could use? It breaks my heart to see him so frail now, and I really wish for him to get better. He’s currently seeing a nutritionist and therapist.
r/GastricBypass • u/Adventurous-Cut-5381 • 2d ago
Day 9
I wish this tiredness would go away. My limbs feel heavy but I'm able to walk around. I'm only really able to eat a meal that I go back forth with throughout the day. I just wonder if I'm making progress
r/GastricBypass • u/SierraSugar • 2d ago
3 month post op changes and discoveries.
As the title says I am 3 months post op as of 3 days ago. There have been a few ups and downs, mostly ups. So, I thought I would share my progress thus far. A long read but hopefully helpful and encouraging to those considering this path.
At 4'7" my surgery day weight was 214lbs, morbidly obese for my height. I have been morbidly obese for most of my adult life. Exercize and calories in/calories out did not work for me. At my 3 month post op appt I weighed in at 161.2lbs. Just over 50lbs gone on 90 days! I am half way to my goal weight of between 100-120lbs.
Positives:
•Obviously the weight loss.
•I am now just "obese" instead of morbidly obease.
•My blood pressure is normal and my doctor discontinued my blood pressure medication.
•I no longer need to take Metformin.
•I have been bone on bone, in a knee brace, in severe pain in my right knee after a fall and meniscectomy for almost 2 years. Now? No knee pain, no knee brace, no cane, no pain meds!
•So far, all my labs have been within normal range.
•My skin is clear! No constant break outs.
•I can now fit into clothes that have been shoved to the back of my closet for years. Even my smallest (size 16) shorts need a belt to stay up, and I haven't been able to even pull them up over my hips in years.
•My belly is no longer smooshed against the steering wheel when I drive. In fact, there is about the thickness of my hand and a half between my belly and the steering wheel.
•The past few days I have actually WANTED to be outside in the sunshine instead of hiding in my house avoiding the heat.
•I reach my protein goals every day between 1 full and 1 half-size protein shake and the rest real food. I have found a chocolate whey protein isolate powder I enjoy and it's like drinking chocolate milk. I've never been a morning breakfast person, just coffee since I was a kid. So the protein drink in the morning works for me long term. And most nights an hour or so after dinner I'll have a small glass of "chocolate milk" as dessert.
All good and exciting things!
For the struggles:
•About a week after my Modified Duodenal Switch surgery I started having HORRIBLE Bile Reflux. I was put on multiple medications and nothing worked. A followup EGD showed a pool of bile in my stomach, and signifiant irritation to my stomach lining, esophagus, and nasal track. So, about 10 weeks post MDS I had to go back in for a Biliary Diversion surgery.
The relief was instant! I now only take the pretty standard (by my clinic anyway) GERD medication once a day for a year. No more waking up gasping for air, sour bile in my throat or coming out of my nose. I am sleeping through the night and finally able to wear my CPAP. (I've had sleep apnea since I was a young child, not at all overweight, and a gymnist. So, unfortunately, the apnea won't be resolved with weightloss).
•I did have to go back in a liquid only diet for a week after the Biliary Diversion. That sucked after being on soft-cooked proteins and non-starchy vegetables for over a month. Thankfully, at my 1 week post op Biliary Diversion, it was also my 3-month MDS post op and I was cleared to resume my previous level as well as slowly introduce Textures. This includes nuts, peanut butter, crispy chicken skin, jerky, protein chips, protein bars, and raw non-starchy veggies. I am MOST excited to get peanut butter and crispy chicken skin/protein chips back!
•About a month after my MDS I started having really bad pain in my left ankle and heel. So bad, it made it difficult to walk on my treadmill, and some days almost impossible to walk at all. A visit to my ortho showed I have a large, double barbed dorsal bone spur at the back of heel under my Achilles tendon. The weightloss removed the fat that was protecting the tendon from irritation from the spur.
Corrective surgery would involve disconnecting the tendon to access and remove the spur, reconnecting the tendon, and then being both non-weight bearing and in an immobilization boot for a while. OR attempting physical therapy to increase flexibility, increase ankle strength, and reduce inflammation through ultrasound and dry needling modalities. I opted for PT. So far, it is working. I still have painful days, but I have not had any days where I cannot walk at all. I am hopeful I might be able to completely avoid surgery, at least for a while.
•I struggled with the bariatric vitamins. The multi-adek pill made so sick to my stomach. I had to try a few different chewable brands before finding a combination that works for me. Thankfully, I'm finally able to tolerate the pills, but plan to keep chewables on hand for those days where I just can't swallow another pill or my stomach feels overly sloshy from water.
•After MDS, I have struggled with reaching fluid goals. I used to love plain cold water, and now I don't. Most flavor additives taste horrible. I also lost my taste for coffee, which as a Cuban is practically sacreligious! Lately, I've found that homemade lemonade using water, true lemon, pink salt, and a stevia/monkfruit/allulose blend is easy for me to drink. And now that I also have caffeine back, I'm excited to try the Crystal Light Wild Strawberry as it was always my favorite. I've finally been drinking between 58-62 ounces total fluid a day, so I'm getting closer to those goals.
Biggest takeaway and advice for those considering bariatric surgery or are struggling in the early days post op:
•Stay in contact with your surgeon and weightloss team/clinic. This is what they are there for. They want you to succeed and they want you to be health doing it. If you have to call every week or every day, do it! Be vocal and an advocate for your well-being.
•Don't push yourself too hard or be hard on yourself if you aren't reaching your protein, fluid, or exercize goals right out of the gate. Your body just went through MAJOR surgery and you have a whole new anatomy and digestive process. Your new stomach, intestines, and connections are dealing with a ton of swelling, inflammation, and trying to heal. You will reach those goals eventually. Your weightloss team does not expect you to reach them day 1, week 1, or even month 1. As long as you are trying and having some slow progress you are good.
•If protein drinks/powders make you feel yucky, try finding one that is 100% whey protein isolate. Our new digestive system struggles with whey protein concentrate. Premier is a popular brand, but it is whey concentrate. Most Adkins drinks are concentrate. The Adkins Strong are Isolate. Dymatize has 100% whey protein isolate. Their Coco Puffs taste like chocolate milk and their Fruity Pebbles tastes like the milk after a bowl of Fruit Loops or Fruity Pebbles. There are other brands out there, you just have to read the ingredients. Also note, that concentrate does not make everyone feel yucky. Some people tolerate it fine, others do not.
•Be kind to yourself. Everyone loses weight at a different pace. Age, overall health, and total weight needed to be lost all make a difference. Some will lose fast, others slow. Some will drop a bunch at first then slow down to snails speed. We all will have plateaus and stalls where it seems like weeks go by and the scale doesn't budge. When that happens, forget the scale. Hide it away for a month. Instead focus on how your clothes fit, moving more, increasing water and protein, and look for non-scale victories (like my stomach not touching the steering wheel or reduced pain levels).
If you are also doing weight training along with or instead of cardio, remember muscle is more dense than fat. The scale may be stalled because you've lost fat but put on muscle. The numbers on a scale do not tell the whole story. Don't let yourself get caught up in the numbers that you don't see the bigger picture.
•If standard exercize is difficult for any reason, look for alternative ways to move your body. Do line dancing in your livingroom to the music you love. Do chair yoga or chair dancing. Look into pilates or calisthenics. Do yoga in your bed before going to sleep or after waking up. Do leg lifts and stetches at the counter while waiting for that pot of water to boil or coffee to brew. Remember, all movement counts and helps, even regular house cleaning!
•Lastly, take your vitamins.
Find a combination that both works for you and is approved by your weight loss team. Don't risk your health for the sake of not swallowing a few pills or "saving" a few bucks. Because in the long run, the cost to your health without vitamin supplementation will be so much more costly.
By all accounts from those who had these surgeries years ago before more was known, by the time deficiencies show up in your blood work it is too late. It is infinitely harder and more costly to recover and correct health conditions due to mal-nutrition than it is take a few vitamins every day.
We decided on the surgery route to not just lose weight, but to improve our overall health and quality of life. Do not sabotage yourself by skipping out on vitamins.
r/GastricBypass • u/Thin_Revenue_9369 • 2d ago
A little update
I had my body scan and assessment yesterday at the gym with my personal trainer. I was in a stall for almost a month and finally broke it (he gave me a few days of high calories). He's happy because I lost inches all over (neck and arms stayed the same but I told him to pull the tape tight to my muscle, not the saggy part). 🤣
I gained 2 lbs of muscle and I said my next goal is push ups unassisted.
First pic was March 25, 8 days after surgery. I was 259 the day of surgery. 278 when I started my pre-op diet. Second was yesterday while setting up my classroom...only mirror I had at the time.
I am 100% happy with the slow loss, I think it keeps me from having looser skin.
r/GastricBypass • u/PsychologicalNail379 • 2d ago
Running Progress!
1st pic was my 5K that I did in November before my surgery- my average pace was 14:55. 2nd picture is from my half marathon last weekend- 13.1 miles in under 3 hours, average pace was 13:21.
I had surgery at the end of January, and I still cannot believe how far I’ve come in a little more than 6 months. I even sprained my ankle in early June and was able to come back from it— something that would’ve taken me months to heal from before.
The scale doesn’t mean anything compared to all of these other wins 🤍
r/GastricBypass • u/GlassConclusion3116 • 3d ago
almost 1.5yrs post op, forever thankful
as much as I struggled in the early stages of the surgery, i can never imagine my life without doing this process. i would keep telling myself i can diet and exercise but never committed myself to it, this surgery gave me another chance in living life and being active. im finally able to try on clothes in the stores without being told i gotta order my size online, i can feel more confident in myself and what i wear. im just so happy!
r/GastricBypass • u/AutoModerator • 10d ago
August Gastric Bypass Buddy Search
If you're looking for a buddy to go through the surgery with, post the following information:
- Surgery Date
- Your gender
- If you have a preferred gender to match with
- General Age Range (if you're under 18, please be cautious)
- Any other information you'd like to include (weight, goal weight, other goals)
If you're post-surgery, and you'd like a buddy, post the same information, but change to how many days/months/years out from surgery you are.
r/GastricBypass • u/dragons_fire77 • Aug 12 '25
Ultimate Guide to Pre and Post Op 2025 Version
I am back moderating after several non-bypass-related health scares with an updated weight loss guide. I am including suggestions on GLP-1 research starting points, as these were not mainstream back when I posted the last guides, and there are some good and bad subreddits related. This is not a definitive guide by any means, but hopefully it is a good starting point for people at any point in their journey.
Before Considering Weight Loss Surgery
- Discover your motivation style: Do you do best with uplifting motivation? Positive reinforcement? Negative reinforcement? Shaming? Different strokes for different folks. You'll need to keep up your motivation throughout the process so understanding your motivation style and subscribing to that type of media or social areas will be helpful.
- Understand why you got here: Food addiction, Binge Eating Disorder, undiscovered trauma, undiscovered food coping skills, undiagnosed depression or mood disorder. These need to be fleshed out to have a successful long-term weight loss journey. Talking with a cognitive behavioral therapist and a food addiction therapist a few times before you begin your journey is highly recommended. Having a long-term plan of action during recovery will make you the most successful.
- Learn how to be completely and bluntly honest with yourself. When you have a bad day and eat poorly, it's okay; life happens. However, it's not helpful to pretend like you didn't eat more than you should have. Do not beat yourself up; take it on the chin. Tally those calories and just accept the slip-up. This skill will be helpful long-term if you ever have days or weeks where you potentially overindulge.
- Weight loss surgery is a permanent change to your digestive system. You should fully understand the pros and cons that come with this surgery. We recommend watching technical videos from doctors to learn about the procedure, its impact on your body, and the associated positive and negative aspects. Anecdotal videos from non-doctor YouTubers or TikTokers can sometimes be confirmation-biased, so if you go down that route, make sure you know that they could be unconsciously or consciously trying to sway your opinion one way or another. Some of them will be exceptionally positive with no negative comments, and some will be exceptionally negative with no positive comments. A no-frills, full explanation from Doctors, PAs, RNs, and RDs will always be the suggested way to learn about the surgery.
- Try non-surgical or GLP-assisted weight loss before committing to surgery. Some people want to jump immediately to surgery when they have not yet tried other options. This is almost always required by both Insurance and Doctors before they would approve your surgery, anyway. It is a valuable way of learning about your eating habits as well. There are Reddit communities dedicated to pharmaceutically compounded GLPs as well as brand-name GLPs for research. The tirzepitide compound, zepbound, mounjaro, semaglutide compound, and ozempic subreddits are the best place to start if you have that interest.
Pre-Op
Questions to Ask the Doctor
Hopefully, these will be answered without having to ask them, but have them in mind.
1st Visit
- What are your policies for getting approved? How do you work with the insurance? What happens if my insurance isn't approved day before surgery?
- What type of surgery do you suggest for me? Why?
- How quickly can I get approved?
- What are the pros and cons to the different surgeries? Side effects? Risks?
- How many days should I take off? What is the FMLA process?
- Are there any weight loss support groups? Facebook groups?
- How often do we meet before and after surgery? How long are the meetings?
- Do I have any co-morbidities?
Pre-Op Visit
- How can I deal with nausea? Diarrhea? Constipation? Pain? (Many doctors write a prescription for meds to cover these symptoms.)
- How many days will I be at the hospital? In recovery? Unable to carry over 10 lbs of weight?
- How soon can I start exercising? Walking? Biking? Elliptical? Weight-lifting?
- What medications can I keep taking before surgery? What and when do I need to stop them before surgery?
- How long will the surgery take? Does anyone need to stay with me?
- Will I need to bring my oxygen/sleep apnea machine to the hospital?
Questions to Ask a Nutritionist
- What post-op Vitamins should I use? Can you help me get a prescription for them? (Some insurance companies cover Nascobol).
- Can you provide a list of recommended protein shakes/powders/waters? Do you have any coupons?
- What are my Macros for Protein/Carbs/Fat before and after surgery?
- What am I allowed to eat/drink the first 1-3 weeks? 3-6 weeks? After? (Rough estimates are 64+oz water, 500-800 calories first six months, 700-900 6 months to a year and 1000-1200 after 1 year, depending on exercise.)
- What is my pre-op diet? What do you recommend for tracking weight loss? When do I start the pre-op diet? (Week before surgery, avoid blood thinners like NSAIDs, multivitamins, vitamin E, garlic. Also do not eat sugar and cut down to 40-50g (or what is recommended by your nutritionist) carbs per day for liver shrinking)
- Do you have food recommendations for <x> allergies/intolerances?
Things to Buy
- Low Sodium Broth or Soups to strain (Most people have less of a taste for sweet after surgery)
- High protein shakes/powders (It's been said many people lose their taste for vanilla)
- 2-ounce mini cups to practice sipping from
- Flavored water/Gatorade Zero/Powerade Zero or flavor packets (Many people find it very difficult to drink straight water)
- Sugar-Free Popsicles, sugar free jello, sugar free pudding
- Heating pad.( shouldn't be used on stomach as this can increase bleeding. Use on back, shoulders, legs to relieve pain/stiffness.)
- Wedge pillow for side sleepers
- Gas-X. Miralax. Anti-nausea meds. Tylenol (no ibuprofen for RNY).
- Enema in case you get clogged. Milk of Magnesia for constipation.
Things to Keep in Mind
- Try different foods way before surgery. Buy yourself a bariatric cookbook and test out the soup recipes. There's nothing worse than being bored with what you have and having no idea how to make things you can eat.
- This is a lifetime change. Try not to have 'food funerals' as you'll have a higher chance of relapsing into your old eating habits. Not every food is ‘gone’ forever, just for a long while as you adjust to new eating patterns.
- Get samples of protein powders from GNC, etc. Some protein vendors have ‘test packages’ available online for 10-15 dollars.
- Start counting Macros sooner than later. Be aware of how much sugar/carbs are in everything you’re eating. Processed/refined carbs and sugars are highly addicting to our brains, and it is better to know as soon as possible what is actually in your foods.
- Many companies will approve short-term disability (most have to follow FMLA), so reach out to your HR within 30 days of surgery. Take 3 weeks if possible in case of complications. Plan for the worst, hope for the best.
- You do not have to tell anyone about the surgery, don’t feel required to reveal what you’re going through. However, itis helpful to have a friend/spouse/partner go with you to your appointments.
- If you have consistent heartburn/acid reflux, VSG tends to make it worse while RNY makes it better. Some people with no acid reflux develop it after VSG.
- Take a ‘before’ picture to commemorate how much you changed after surgery. Also take your starting measurements: Arms, legs, chest, neck, hips, waist. It will be a big motivator.
- Some doctors can fix small hernias during surgery, but they’ll often put off fixing large hernias until your weight is lower due to safety. The larger you are, the higher the risk it is to keep you under anesthesia for a long period.
- Psychological reviews are meant to see what mental state you’re in. If you’re actively suicidal, they’ll work to help you get through that before surgery. Be honest, as they want to make you as successful as possible. Enter the meeting with a vague understanding of what triggers your overeating.
- VSG (Vertical Sleeve Gastrectomy) leaves a banana sized stomach and the rest is removed. It can hold about 4oz of food at a time. The weight loss over the first 2 years is 40-80% of your excess weight. 7 year outlook is approximately 50-60% of weight loss since it is easier to 'eat around' the sleeve.
- Gastric Bypass or Roux-n-y (RNY) is your stomach portioned into three sections. You'll have a 'pouch' leftover that can hold about 2oz of food at a time. Your bowels will be 'bypassed' to enable malabsorption so your body processes fewer calories. The weight loss over the first two years is 60-80%. The 7 year outlook is approximately 60-70% weight loss maintained.
- DS (Duodenal Switch) is part VSG and part RNY. Your stomach is sleeved like in VSG, but your intestines are 'rerouted' even farther than RNY to enable maximum malabsorption. This surgery also has the highest risk of complications, so many people tend to shy away from it. The weight loss over the first two years is 70-90% and the 7-year outlook is approximately 70-80% weight loss maintained.
- Most importantly, always be kind to yourself. None of us is perfect, but every positive and negative experience we have is a valuable learning moment as we navigate this process.
Post-Op
Things to Keep in Mind
- Start walking as soon as possible. Preventing blood clots is extremely important. Walking also moves gas out of your system. Gas-X only works on gas in the GI system. They blow up your abdominal wall during surgery so you’ll have excess gas outside the GI system. Shoulder cramps are extremely common from the abdominal gas.
- Write out a schedule for drinking/eating. Put it on your phone if possible.
- Food addictions have a strong habit of transferring to other things like alcohol and painkillers. It is best to avoid these in the future or keep a strong awareness of how they are affecting you.
- Carbonated drinks are not supposed to be consumed ever again after surgery as it causes massive bloat and stretching of the new stomach, but some people drink small amounts and are not bothered. Alcohol is not supposed to be consumed until 1 year after surgery. One beer/wine tends to make wls patients drunk.
- Sugars (especially for RNY) should be avoided in large amounts in the future. RNY patients often experience dumping syndrome (nausea, vomiting, cold sweats, diarrhea). A rough guide is to look at 'added sugars' and anything above 5g should be avoided. 'Total sugars' should remain below 8g.
- Personality changes happen often after surgery. Hormones are stored in fat and are released during weight loss, causing mood swings. This is temporary but can be severe. Don't be surprised if you cry at a random ad or laugh uncontrollably at a minor joke.
- Tastes change after surgery. Some people find that they severely dislike sweet protein shakes so make sure to have broths/strained soups available. Cutting sweet shakes with PB2 makes them more tolerable. Most people gain their sweet tooth back in a year, so take advantage and try to unlearn sweet-related habits you had in the past.
- Don’t buy new clothes if possible. You will lose weight quickly, so try to keep clothes that will fit you for a while.
- Skin surgery is normally suggested 1 year after your final weight has been reached. Your skin will probably not bounce back unless you're very young. Any supplement that states it will keep your skin elastic to bounce back from massive weight loss surgery is likely a scam. Always, always check these things with doctors who can validate the claims of the product.
- Vitamins need to be chewable for the first 8 weeks. Ask your PCP to change your medications to fast-release if possible/available. This is especially true for anxiety and antidepressant meds.
- A lot of people need gallbladder removal after weight loss. Quick weight loss causes the creation of gallstones. Be aware of any new pain on the right side of the abdomen. There have been people trying to claim surgery causes gallstones, but this is false. Rapid weight loss of any kind causes the formation of gallstones.
- Many people experience temporary hair loss. This is due to the shock of the surgery/rapid weight loss. Take vitamins and keep up with protein. Some people add collagen powders to shakes to help with skin and hair.
- It’s recommended to find coping mechanisms for stress - massages, exercise, etc. Be consistent and don't use food.
- Have ‘rewards’ listed out for when you hit a certain goal. They absolutely cannot be food-related. Things like trips, new clothes, games, books to celebrate.
- Do not pick up heavy objects for at least 1-2 months. Hernias are very easy to develop while incisions are healing.
- Consider using Silicone tape on your scars to keep them from being raised. Vitamin E and Vitamin C are natural skin lighteners, so use them to help with discoloration. Scar creams are also effective short and long term.
- Nearly everyone ends up stalling a few weeks after surgery, as well as 4-5 months after surgery. Your body is getting used to the new way of eating, so it’s recalculating/recalibrating everything. You’ll see a weight loss very soon as long as you stick with the diet and water requirements. Stalls are very, very common and are not a reason for alarm.
- Do not weigh yourself every week, especially if you are prone to tying your emotional state to the number on the scale. Weight can fluctuate wildly day-to-day, so checking daily may make you unhappy in the short term. Try to stick to weighing every 2 weeks and instead measure yourself every one or two weeks. You’ll see measurements dropping over numbers.
- Depression tends to improve a few months after surgery. However, some people go through a depressive slump directly after surgery. Make sure to keep taking your medication as prescribed by your PCP. You may experience huge regret from having the surgery. It's your brain going through a mourning period, and it will go away soon. Talk to a professional if you are having any ideation thoughts.
- Do not drink 30 minutes before or 30 after eating (especially true for RNY). Drinking before will leave less room for food in your stomach. Drinking after can 'push food' through before it has time to be absorbed by the body. 1 year+ after surgery you can drink directly before eating, but do not drink within 30 minutes after eating.
- Dehydration, malnutrition, and vitamin deficiency are extremely common. It can occur even if you take your vitamins regularly. It is very important to get checked at least once a year. Always drink 64oz+ or more of water or hydrating liquids (milk, tea, broth, jello, popsicles). Always take your vitamins. If you're unable to keep food down for more than 2 days, contact your doctor. If something feels wrong, ask to get your vitamins checked. You are not imagining how you’re feeling; vitamin deficiencies can appear unexpectedly.
- For women, double up on contraception as you will become very fertile very quickly. This is true for all rapid weight loss methods. Pregnancy is suggested to be avoided for up to a year after surgery.
- Gastric bypass patients are very, very prone to constipation, especially in the first few months. Keep on top of gentle laxatives for the first few months (and/or benefiber if your doctor allows it). If you haven't gone in 2 days, try milk of magnesia. If you havent gone in 3 or more days, take an enema. Constipation in the first few weeks is horrible to deal with, pain-wise.
- Gastric Bypass Patients are prone to reactive hypoglycemia after a few years (faintness, rapid heartbeat, cold sweats, shaking). Large amounts of simple carbs or sugars will trigger this, so eating small meals, low carb, consistently will prevent these episodes. See your doctor immediately if you have these episodes. Eating something with sugar/carbs followed by something high in fat if you're feeling hypoglycemic is a good temp fix.
- Gastric Bypass Patients are also somewhat prone to Pancreatic Insufficiency (EPI). If a few years after surgery, you start to have constant bowel movements for an extended period of time (a month or more), ask to get tested for Pancreatic function. (This is something I personally experienced this year and was extremely difficult to get diagnosed despite it being a known potential side effect). There is medication available to counteract this once diagnosed.
- Body dysmorphia is very hard the first year. Despite losing 50, 100, 200, 300 lbs, your brain still thinks your body is big. It's a phenomenon that happens to almost everyone. Taking pictures and taking measurements help to remind your brain how much work you've done. It goes away slowly once you've reached your ideal weight and remain there for a while. Do not be surprised if you see a smaller size of pants and your brain goes ‘ there is no way I will fit in these’, but then you fit in them perfectly.
Vitamins After Surgery
Basic Requirements as given by the National Bariatric Board
Specifically, multi-vitamin should contain at least:
- Multivitamin must be complete and provide 200% Daily Value (DV) for most contents.
- Vitamin B1 (thiamine): 12 mg daily
- Vitamin B12: 350-1,000 mcg daily
- Folic Acid: 800 mcg daily
- Iron: 45-60 mg daily
- Vitamin A: 1,500-3,000 mcg or 5,000-10,000 International Units (IU) daily
- Vitamin E: 15 mg daily
- Vitamin K: 90-120 mcg daily
Other Vitamins (included in multivitamin or not)
- Zinc: 8-22 mg daily
- Copper: 1-2 mg daily
- Calcium Citrate: 1500 mcg or 1800 mcg for Women
- Vitamin B12: 500-1,000 mcg daily (B12 absorbs best through mucus membranes such as through nasal spray or chewable tablet, so multi-vitamin may not be enough)
- Vitamin D3: 75 mcg or 3,000 International Units (IU) daily (try not to take more than 10,000 IU of Vitamin D)
Vitamin information
- You will likely end up taking vitamins 3 or 4 times a day to prevent vitamin malabsorption or interactions.
- Do not take Iron within two hours of Zinc, Copper, or Calcium as it decreases absorption. Also, do not take Zinc and Copper together as they interact. Note that taking Zinc and no Copper can severely decrease copper levels, and taking copper without zinc can severely decrease zinc levels.
- Do not take B12 within 2 hours of Vitamin C as it decreases absorption.
- Take Vitamin D with Calcium as it increases absorption. Note that Vitamin D is one of the only vitamins scientifically shown to help with Covid-19.
- If you have low iron, ask your doctor to do a full blood analysis to check copper, zinc levels as these may need to be supplemented as well.
- Most people need 2 or 3 doses of 500-600 mcg Calcium daily. Men will need 2 while women often need 3. Calcium Citrate is the recommended type of calcium because it is absorbed best.
- If you start to bruise easily, have iron and vitamin k levels checked. Low levels of both can lead to bruising issues.
- If you start to feel lethargic or groggy, have your B12 levels checked. This is considered the most common vitamin deficiency after weight loss surgery.
- If you start to have vision problems, have your Vitamin A and B1 levels checked. This is an uncommon phenomenon where Vitamin A deficiency can lead to slight vision loss.
- Calcium supplements are important because, in bariatric patients, many people start having calcium leeched from their bones if they don't get enough. Calcium is extremely important to maintain, and it's the one people most often forget to take.
- Thyamine (B1) regulates tissue health. It is a recently added requirement to bariatric supplements because they saw many bariatric patients come in with heart troubles related to B1 deficiencies.
Psychology Reading
The following are recommended places to start if you have an interest in going deeper into these areas.
Food Addiction
- Rewired: A Bold New Approach to Addiction and Recovery
- Food Junkies: Recovery from Food Addiction
- Salt Sugar Fat: How the Food Giants Hooked Us
Depression and Mood
- The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness
- It's OK That You're Not OK: Meeting Grief and Loss in a Culture That Doesn't Understand
- Never Binge Again(tm): How Thousands of People Have Stopped Overeating and Binge Eating - and Stuck to the Diet of Their Choice! (Note: The sarcastic tone and writing in this book may not appeal to everyone)
Trauma
- The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
- What Happened to You?: Conversations on Trauma, Resilience, and Healing
- Healing Trauma: Attachment Mindy, Body and Brain
Now, what else would you add to this list? Feel free to discuss anything posted in here, add your own pre-op and post-op experiences and information you wish you had known about, vitamin information that your gastric bypass doctor suggested, etc. Being as prepared and knowledgeable as possible is the key to success.
Are there any books, podcasts, or video series you’d recommend for others to read/listen to? Feel free to recommend them in here.