Doubts....

I have a lot of doubts I am little bit confused so I'm hoping to obtain a little bit of clarity. I have just finished my 6 month weight loss and my provider is submitting it for approval to my insurance BCBS. however I have been reading online and making sure I educate myself on the VSG procedure and what I'm reading does not match what my provider is telling me. so I'm a little lost on what to expect. I have read online that most providers have a patients do a liquid diet before surgery which my provider has never mentioned. I also see a lot of people go on a puree diet after surgery and my provider does not do that, she wants us eating meals right away after surgery. is this normal??? I asked her about the puree and all she said was that we weren't baby's to be eating puree we should be able to chew our food well enough after surgery so I'm a little worried that its not safe to do so. I went in for my 6 month weight loss and I met with the nutritionist and the nurse practitioner and I was expecting to be more educated on the process but all they wanted were logs of my food I had to figure out what food to cut from my diet and what to stop eating. I would mention things I found online about not being able to drink carbonated drinks or carbs and all they said was to focus on my diet now that everyone's journey is different. i was also curious about alcohol consumption I was told that after my VSG I wouldn't be able to drink any alcohol at all ever, and after talking to a person that had a VSG years ago she told me she was able to drink a glass of wine here and there so I have all these questions that they never cared to answer and I feel like I'm no were near prepared and I'm having doubts about scheduling my surgery or maybe finding another doctor, but if I find another DR will I need to start my 6 month journey again and go thru another prior auth? I really want to get my VSG surgery and I don't want any doubts to stand in the way of it. I guess I need answers and im frustrated that my provider keeps giving me the run around when I ask all these questions. I'm so annoyed and Im scared that if I look for another provider I will get the same answers or have to restart my process AGAINNN. any advise?

Every program is different. Some surgeons require a liquid diet to shrink your liver before surgery and some don't. If you've been losing weight for six months, your liver will be smaller than it was anyway. Some surgeons require a liquid diet for a month post op and some have patients eating right away. It's all ok as long as you trust your surgeon and follow their rules.

It is best to stay away from alcohol forever because it is empty calories and there is a higher chance of becoming an alcoholic post op. But some people drink every once in a while and that's fine too.

Most people find that weight loss is faster and maintenance is easier on a low carb diet, but some people count calories and don't care about carbs. If it works for them, then that's not a problem either.

Hello and welcome to the forum.

I think that the immediately pre and post-op diet requirements vary widely between surgeons. For example, I had 10 days liquids pre-op and then 14 post-op, followed by 14 days of purees. But other people have clear liquids and some go straight to soft foods. When it comes to this part of the diet, it's best to do with your surgeon's plan because they know what works best for their patients.

It's bothersome that you're not getting any information about what to eat, though. That doesn't seem like a road to success. Have you asked what sort of success (short term and long term) patients in their program have?

Here are my "basics" that I came to based on all of my research both here and from the information my surgeon did give me.

1. Prioritize protein and water
2. Deprioritize carbs, especially the refined and processed ones
3. Make the most of healthy fats
4. Eat three meals a day with no snacks
5. Avoid liquid calories (protein shake for breakfast is my exception since I've never liked putting solid food in my stomach first thing in the morning)
a. Don't drink with meals or for 30 minutes after eating
6. Weigh portions and track/log what you consume
7. Eat mindfully and with no distractions aside from real live people
a. Try to eat at a table
8. Move as much as possible
9. Weigh yourself daily
a. But focus on the trend of your weight, not the day to day fluctuations
10. Be kind to yourself

Carbonation might not feel great early on, but there's no reason to avoid it for your entire life. Most people here who are successful long term keep their carbs low. The general rule of thumb is that you can start drinking alcohol when you want to stop losing weight - but we're at high risk for transfer addiction and liquid calories aren't something you want to make a habit of either.

Not knowing you, it's hard to give you advice on this. I like doing my own research and figuring things out, so I needed my surgeon to be a good cutter. I found my own therapist and figured out my own way of eating. But this all takes a lot of time and effort. If you're willing to do that, stick with the team you've got and just be prepared to do all the work yourself. If you're not, then you'll probably want to transfer to a better program.

There are as many different programs as there are surgeons who do wls! Mine didn't have me do a liquid diet beforehand either, and given how much people seem to suffer on it, I'm glad. I was asked to lose 10 pounds in a little over a month, however I wanted.

I didn't have a puree phase, but I was on protein shakes and liquids only for 3 weeks after surgery then onto soft foods. Some people get to eat right away. I wouldn't worry that because your surgeon isn't restrictive that you won't be getting good care. But know that if ever doing something doesn't feel right, you can always back up a bit. For example, if food doesn't feel good, switch to protein shakes for a while, then try again.

My surgeon was all about the fat free dairy, which I am vehemently opposed to on both a culinary and common sense level, so I discarded that piece of advice. And I'm doing fine with my weight loss. So I think you'll find there is room to find what works best for you. OH is a great place to learn what worked for the vets here. Some might feel right for you, some might not, but at least you'll be making educated decisions for yourself.

There is an interesting thread right now about alcohol that might be good to read.

Oh my gosh - I'd forgotten that my NUT was also a fat free dairy proponent. I just nodded and smiled and thanked her for her information :P

It might be worthwhile to talk to another surgeon if you aren't happy with how they do the follow up. All your records should transfer so no need to start over if you decide to go with someone else.

From the few months i've been on this site, it looks like all surgeons vary a bit in their post op treatment. I did full liquids 2 weeks pre and post the surgery. After liquids, i didn't have to do purees and went to a soft diet so I eat a lot of fish and yogurt. I do eat the shunned mashed potato but my weight loss has been great so I'm not worried about it. i'm on soft food until week 12 which is coming up and it is a challenge to eat out (not impossible) just a challenge. I've always been a pia in restaurants so it doesn't bother me lol.

I haven't tried carbonation and do hear that most people can't tolerate it. One of the reasons i chose the VSG is that my surgeon said you could still have alcohol. I'm single and all my friends (and co-workers) are pretty big drinkers so being able to have a few drinks once in a while is part of my lifestyle. I told myself that I wouldn't drink for 6 months post op which is what they recommend. I have a co-worker who had the surgery a year before me and she started drinking pretty soon after (maybe 6 weeks out) where she would just have a glass of wine. I think it made her lose weight slower...

Everyone's body is different so you don't know what will work for one person will work for you. There has to be some give and take when you have 3/4 of your stomach cut out. My bottom line is that any change is worth being a normal weight. Good luck in your decision!

Welcome to the forum & yes everybody's plan is different & I would be leery of any Dr that gives you the run around when you ask questions or gives you answers like you're not a baby when it comes to purees. Them telling you to depend on you chewing your food really well is a red flag to me. This is major surgery & introducing regular foods "that you chew really well" can be too much for a fresh newly cut up stomach.

Proceed with caution, even if you have faith in your Dr, doesn't mean that they can't make mistakes.

I totally agree with this.

You should feel comfortable with your surgeon and team, and they should be fully answering your questions.

My surgeon doesn't do a formal pre-op diet unless she sees evidence of an enlarged liver. All she asked me to do was basically the SlimFast plan but with better protein shakes, LOL. 2-3 shakes a day, plus one low-fat meal, and I could snack on fruit, veggies, and low-fat stuff if I needed (and boy, did I! Pre-op dieting was hard for me.)

Post-op, she does liquid plus things like yogurt and strained soups for about 2 weeks, and she does skip puree because she says there's enough healing at that point that if your teeth work and you chew well, there's not much benefit to puree in her mind. She had me go straight to "soft" food at that point. I wasn't on a "full diet" until about 6 weeks post.

As a nurse, I will tell you that in addition to whatever your doc says, it's ALWAYS a good idea to progress food VERY slowly after a major stomach surgery, which this is. Start off with the protein shakes, and when you do start adding foods, start with the blandest, softest, and MOISTEST (this is very important) foods. Add ONLY ONE food at a time, and IN SMALL AMOUNTS. Make sure it's being tolerated well and increase the amount with that well tolerated before moving on to the next food. It can seem like it takes a REALLY long time to get back to a "normal" diet this way, but it's really the best way to see what you can and cannot tolerate while healing, and even when you are "done" healing. Some people have long-lasting food intolerances, and we're all different in our healing process and tolerances.

My surgery was open and I had no pre-op diet at all. I was eating soft foods while still in the hospital and handling them fine so they released me to eat what I wanted, suggesting to concentrate on moist an tender meats and cheeses.

Some docs have the same post op diet for every procedure, but really, they are all different, and a sleeve stomach can handle food better than a RNY pouch.

You shouldn't drink alcohol your first year while you are losing rapidly. This is hard enough on the liver. Once your weight stabilizes you can have some but beware you'll be a cheap date.

Thank you I feel a lot better with these answers. its nice to know more information :)