New member - question about psych meds and bariatric surgery

Hello, I'm considering VSG and I have bipolar disorder, so I take a lot of medication that makes me hungry and thirsty. Obviously, that has made weight loss hard. I've lost large amounts of weight before but always gained it all back, or almost all of it. I am wondering how the psych meds are handled during the surgery, especially since I'm reading that people get moody. Also, because my medication makes me really, really thirsty, I drink a lot of diet soda, because the carbonation and acidity is much better than water at keeping my mouth moist, but I'm reading that you can't drink carbonated drinks. Also, I need to drink a lot to get my food down, and I'm reading that you can't drink while eating. How do people who take psych meds handle this?

Finally, how do you keep eating healthy foods? I feel like, if I could have done that, I wouldn't have gained the weight back the last three times I lost it! I mean, if I could stand just eating protein and vegetables for the rest of my life, I wouldn't need the surgery....

First of all, talk to your doctor about possibly changing your meds to something without those side effects. Second, NO you CANNOT have soda. I had the same problem as you and I switched to a Crystal Light flavor that I love. In fact, I buy the little canisters by the 12 pack on Amazon! You will not be able to drink when you eat, or it causes pain. Also, talk to the doctor and pharmacist about relieving the dry mouth from your meds. There are rinses, etc. that can help with that.

You will also have to cut out carbs and keep them out for the rest of your life. The surgery is only a tool and not the "end all-be all" to weight loss. You will only be eating 1/2 cup of food 3-5 times a day, depending on your plan. With the protein requirements, that means you will mostly be eating meat, with some veggies. Bread is out completely along with popcorn and other non-nutritious foods. Yes, this means nothing but meat and veggies, sometimes a little piece of fruit.

My advice is to start the regimen now. Not necessarily sticking to 1/2 cup of food, but use a salad plate and fill 1/4 with meat, 1/4 with starch and the rest with veggies. Eat the meat first, then the veggies and then the starch. If you are still hungry eat more veggies. By the time I got to my surgery date, I wasn't eating the starch most of the time.

I know it sounds daunting, but take 1 day at a time and one snack or meal at a time. The nice thing is they have you eat every three hours, so you don't become ravenously hungry, even with the small amount you are eating!

Changing meds is not an easy thing. Finding a medication that works, with side effects we can live with, is a long process of trial and error, and it can take months if not years. Pretty much all meds have some sort of major side effect, so it's not that easy.

Hiya! I have bipolar disorder as well, hopefully I can help out :)

I chose the VSG rather than the RNY because I was worried about my meds not being absorbed properly. So far, at 4.5 years out, I've had no trouble on that front.

When you read about people getting moody, that's likely due to the infamous "hormone dump." Our bodies store estrogen in fat cells, so when you lose a lot of weight very quickly, like you do in the first few months after surgery, all those hormones go flooding out into your system and it's rather like a serious case of PMS. The good news is that it's temporary, and it's absolutely possible to temporarily adjust the doses of your meds to compensate. (I was on Lamictal at the time, which is made less effective by estrogen, so I had to double my dose for about six months post-op.)

Carbonation is best avoided for the first year or so, even if you're drinking sugar-free stuff like seltzer water. It often gives you gas and irritates your stomach. If you find that acidity helps, you can drink things like SF lemonade, or just add lemon juice to your water, and that helps. There are also mouthwashes and toothpastes that can help with dry mouth, I used Biotene when I took Lithium and had that side effect.

Drinking while eating is definitely No Bueno. It'll wash the food right through your sleeve, which basically undoes the benefit of restriction. However, you CAN make your foods moister with things like sauce or marinade. When you're taking tiny bites-- think the size of a grain of rice-- it's also easier for things to get down.

Eating healthy food is definitely an adjustment, and it takes a big shift in your head game. It does get easier as you get into the groove; when you detox from white carbs, people often find that they don't crave them any longer. Plus the reduction of ghrelin that some people experience after VSG makes it quite a bit easier.

Feel free to PM if you have any other questions, I'm happy to help in any way I can!

I don't take psych meds but I can relate to some of what you are saying. I also guzzled a lot of fluid while eating pre surgery. Not necessarily because of dry mouth, but because I found that I wasn't chewing well and was eating too fast, which lead me to drinking to push food down. I find that now that I'm forced to eat without drinking I chew better, and take smaller bites, which allows my food to go down better because the food is naturally moistened in my mouth. This is fairly important with VSG because you are only eating small amounts, and you don't want to wash down your food to quickly into your intestinal tract because you won't feel satiated.

As as far as your eating habits, I'm sure most of us shared your same fear of failure and fear of old habits creeping back into our lives. The only thing I can say to that is you have to be ready, and you have to really want this, because you will need some willpower. The tool helps tremendously, but I think many of us go into this knowing this is our last ditch effort to gain control of our lives, and we really want this to work. It's scary, it's not a sure fire method, and you have to be able to put in the work. I gained weight initially during the pre-op (14lbs). I believe due to self sabatoge and fear, but wouldn't dare let myself move forward until I could prove that I could lose (despite my program not requiring weightloss). I lost 27 lbs. It wasn't until then that I knew I was ready.

I was able to switch to liquid Lithium and a smaller size of Wellbutrin to make getting my pills in easier. Don't expect your surgeon to know anything about psych meds or your psychiatrist/prescriber to know anything about bariatric surgery. You will have to advocate for yourself, do your own research but it can be done.