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Bariatric Surgery Update

June 28, 2017

I’m back from Ireland. It was as magical as I’d hoped. We had such a blast and I’ll always remember the trip, and also how much more mature Wolfie is than me in the context of long lines at airports, even though he’s only 8 (his words: “Of course I do get impatient, mom, but I just hold it inside and I think about positive things like that we’ll eventually be home and that we’ll be able to see our family”).

Also, after coming home yesterday, I went to a nutrition seminar for bariatric surgery with my husband. I have officially completed all the paperwork (tons of it) so right now I’m in the waiting phase, hoping that my insurance clears the surgery soon so I can get on with it. As usual, I’m impatient. I should probably try to channel Wolfie here.

I’m guessing it will be another 6 weeks before I get the surgery, so around August 9th. That’s four weeks for the insurance to clear, and then once that happens, I need to be on a very strict diet for two weeks heading into the surgery. Theoretically I could get cleared in two weeks, and I could even just start the diet early, but since it’s so intense I’m probably not going to start until I have a date.

The strict diet is essentially a protein-drink only, starvation diet meant to reduce the size of my liver in order for it to be not in the way for the actual laparoscopic surgery. It turns out that many people of my weight have “non-alcoholic fatty liver,” which just means a liver that’s bigger and contains more fat than a normal liver. It can get in the way of the surgeon’s tool, which can be a problem. The good news is that livers respond quickly to dieting, so the two week extreme diet goes pretty far in decreasing the size of the liver to a manageable obstacle.

I’ve been practicing making protein shakes lately, mostly with fruit and milk, in order to get used to them, because generally speaking they’re horrible tasting and sickly artificially sweet. I have found a pretty good one though, by which I mean it’s not too sweet, and I just tried it alone with water, and it was actually fine. The trick is: lots of ice and a really good blender. I got a “Ninja Professional Blender with single serve” and it’s perfect.

Also in last night’s seminar we went over the diet for the various stages of recovery. Here’s a cheat sheet:

  1. For the week after the surgery, you’re never hungry and you only drink, but the weird thing is you have to drink tiny 1 ounce cup of water or broth every 20 minutes while you’re awake.
  2. For a few weeks after that you eat every three hours, even though you’re probably not hungry, but it has to be the pureed like baby food or applesauce. The reason is that your stomach is still healing and is swollen, and might not be larger than the size of a straw in places, so larger chunks of food could get stuck. You also drink tiny amounts very often but you can’t drink and eat at the same time.
  3. After that you start introducing slightly less pureed food into your diet. You eventually eat pretty normal food but your stomach is much smaller than before, so way less of it. They suggest you eat mainly protein, and you eat that first, followed by vegetables and fruit.
  4. They also give you the following long-term rules: never eat and drink at the same time. Never drink carbonated beverages. Try to eat on 25% of your diet in fat, and avoid refined carbohydrates forever. Also, take vitamins every day for the rest of your life.

If that all sounds like a major behavior change, you’re right. It’s intimidating. On the other hand, the people I’ve interviewed have all told me the one thing that I think makes it possible: namely, that you’re not hungry all the time, even though you’re eating way less. That small amounts of food fill you up for hours. This sounds like a miracle to me, as a person whose hunger rages at me like someone screaming in my ears on a daily basis. So I’m taking a leap of faith, knowing that I’m pretty good at following plans I’ve set for myself, and also knowing that once you’ve developed a habit, it’s not that hard to follow it.

Categories: Uncategorized
  1. dworfrecaut
    June 28, 2017 at 7:48 am

    Mathbabe, if you are set on surgery no matter what then ignore this post. If you are still considering alternatives then you might be interested in what I went through. Like you I had never been able to diet successfully. I found that in order to lose wait I had to stay hungry, which I managed to do only for for a limited period of time. Eventually something happened, I lost my resolve and regained my weight. That was until I went to see a functional doctor ie a bona fide MD who also got training in alternative therapy and functional medicine, a type of medicine that uses supplements, diet and lifestyle changes to treat the conditions underlying diseases. She run some tests to assess my metabolism issues and vitamin deficiencies. She then put me on on a protein powder, supplements and on the cardiometabolic diet. That diet requires you to stop eating all forms of simple carbohydrates ie sugar, white flour, white rice etc and to eat large quantities of green leafy vegetables as well as healthy fats and proteins. She also told me to hit the gym five times a week. It has worked really well for me, my hunger has gone, I have more energy and I am losing weight. Most importantly because I am French and Italian, I am eating really tasty food, the diet actually gives you a lot of flexibility (except for the protein powder which I call the bfast goop). If you are interested you can look up a Dr here https://ifm.org/ or here https://integrativemedicine.arizona.edu/ there are tons of them in NY. Whatever you decide good luck, you are having a very positive impact on society so all of us have a vested interest in keeping you in good health!


  2. tomtom
    June 28, 2017 at 8:20 am

    Dear Cathy,

    First of all congrats for doing it. I myself i’m morbidly obese and I’ve been thinking about surgery for a long time but never had the courage. One thing that I am afraid of is that I’m going eat even though i’m not hungry (something I do often sadly) and then i’m going to feel terribly sick because of the smaller stomach. Are you afraid of this ?

    In any case I hope you will keep us updated and I sincerely wish you all the best with this courageous endeavour 🙂


    • June 29, 2017 at 7:40 am

      You should look at the duodenal switch or sleeve instead of RNY gastric bypass. With those surgeries, your stomach is sleeved, meaning the bulbous part is removed, leaving it long and skinny like a banana, holding from 3-5 oz. But it is fully functioning, with the duodenum left intact to regulate food going from your stomach to your intestine as nature intended, and not a pouch with your intestines hooked in via an artificial stoma (hole), which causes all sorts of negative side effects (including “dumping,” which causes you to feel sick) and complications. I had a duodenal switch 11+ years ago, and have never regretted it for an instant! Check out dsfacts.com, duodenalswitch.com, and/or dssurgery.com for more information. The sleeve, which is the stomach portion of the DS, is done as a stand-alone for those who don’t have as much to lose, or who aren’t willing to do the full DS because of all the additional vitamin supplements that are needed for a lifetime with the DS due to intestinal rerouting, which causes malabsorption (but that is what helps with maintaining long-term). Best of luck to you!


  3. June 28, 2017 at 9:27 am

    Best of luck, Kathy!


  4. June 28, 2017 at 9:28 am

    I mean Cathy…


  5. Gordon
    June 28, 2017 at 9:31 am

    Good luck with the journey, Cathy! JOOC, are the long-term rules driven by the surgery, or are these guidelines that your doctors would set for anyone?


  6. ionf
    June 28, 2017 at 9:39 am

    Not for nothing, the screaming hunger would probably also go away if you just adopted that diet without the surgery. I’d suggest that’s an experiment worth trying, as you’re committed to the diet anyway and not having surgery is better than having surgery


    • ionf
      June 28, 2017 at 12:32 pm

      As @dworfrecaut says, if you’re not looking for alternatives, then good luck and godspeed. And for credibility, I should share my fat loss story. After our first soon was born in 2010, I weighed in over 270#, which was a BMI of like a hundred. I was also driven by hunger to eat plates of nachos, full ice cream cakes, foot long Pastrami sandwiches and the like. I took on Joel Marion’s cheat to lose diet — carb cycling — and got down to about 235# — not obese ( I’m 6’5″) — that year through a combination of that and his Xtreme fat loss diet, which adds fast days and contracts the cycle to five days. I did a bunch of stuff in 2011, and at the beginning of 2012 I adopted the Primal Blueprint, which is wheat-free, high fat low carb. After our second son was born that year, I weighed in at 211#, normal weight, with a 34″ waist, there smallest I’d had as an adult. In 2014 I went into a muscle building program and hurt myself in 2015, reactivating chronic pain issues and putting myself back at 270# a year later. About two months ago I started carving it off in anger, preparing for the Chicago Marathon, fasting two days a week — the hunger goes away when you go off carbs and you can fast whenever you like — and taking a cold shower every night. I’m taking off about two pounds a week, and preparing to go full keto in less than two weeks, which should accelerate that.


      • June 28, 2017 at 12:36 pm

        Dude, you disqualified yourself from giving me advice when you said “BMI of like a hundred,” when I weigh more than that and I’m 5′ 7″. My BMI is not close to 100. It’s dismissive language, not a good start.

        And as for the rest of your story, no thank you.


        • ionf
          June 28, 2017 at 6:43 pm

          I apologize for offending you. I simply meant to express that I didn’t feel in control of my body composition.


        • June 29, 2017 at 4:57 am

          Totally understood. We’re all looking to be healthy and for some sense of control. That’s why I’m doing the surgery, I think it’s my best bet.


  7. June 28, 2017 at 10:26 am
  8. Kay Milagro
    June 28, 2017 at 2:30 pm

    Here is my smoothie recipe that really does taste good:

    frozen blueberries or other fruit
    a bit of vanilla
    protein powder
    stevia to taste

    Make smooth in a blender. Using the frozen fruit will make it cold and thick; the stevia will sweeten.

    Good luck with your program.


  9. Quartz
    June 29, 2017 at 6:30 am

    Sorry if I feel to comment this late without much expertise, but I’ve read that the science on bariatric surgery is very controversial and there might be serious side effects hidden by those promoting it. And weight gain seems to be a useful adaptation of the body in fighting stress (the reason why so many diets fail), but it still seems to be knowledge confined to the stress research community. Surgery not only does not combat the cause of an imbalance, it might even worsen it, ending up with more serious (but less publicised) metabolic problems. Society has insane standards and a bad attitude towards weight which shall change. Please do check out the research and pop works by Achim Peters in Lübeck before taking a major step!
    In any case I wish you the best!


    • June 29, 2017 at 6:44 am

      Actually, we don’t know why we are all so fat:

      Also, bariatric surgery is the only known way to lose weight permanently:

      I agree about the standards, and I agree they should change. For my part, I love my round body and I’m dreading losing it.


      • Quartz
        June 29, 2017 at 9:35 am

        Thanks for your kind answer.
        I’ve read that post, and the “confusion” seems particularly consistent with the stress factor theory (which actually seems to have been repeatedly verified). Diets and exercise might increase stress; chocolate, cheese and fats are well known to act as stress dampeners and thus become correlated as other factors increase it, etc…

        I can’t summarize quickly the book now unfortunately, but really please have a look at the issue.
        The article you’re sharing seems the usual advertisement common in the bariatric surgery field, however it references to a paper like “From 1376 articles, 9 studies were included in the systematic review (SR) and 6 in the meta-analysis (MA)”. Of course I do not need to explain the significance and sampling problems here, right?
        I checked and the problem of the literature such promotional material uses are studies w/o RCTs, that is with unknown sampling approaches, when studying resulting health.
        Actually various more serious studies report increased suicide and incident rates after surgery. (e.g. Tindle 2010 – Risk of suicide after long-term follow-up from bariatric surgery, etc…). There are increased cortisol concentrations (Manco 2007, Valentine 2011)), various sugar metabolism problems (Marsk et al. in Diabetologia 2010), increased drug consumption (Conason 2012, King 2012)… I can give full references if you like. Just don’t take it lightly; it’s only relatively new stuff, not that it’s not solid enough to be taken seriously.

        Liked by 1 person

  10. June 29, 2017 at 7:43 am

    Regarding protein, try the Chike coffee protein powder if you like coffee! It doesn’t have the nasty whey aftertaste that most protein powders do. (The other Chike flavors do, including the mocha, but not the coffee flavor.) I blend it with cold coffee, ice, and a splash of dark chocolate almond milk, and — voila! — yummy frappuccino!


  11. June 29, 2017 at 7:47 am

    It sounds like you are having an RNY gastric bypass. I hope you have considered the Duodenal Switch — it is much more effective for long-term weight loss; you are actually able to drink while you eat since you have a full-functioning sleeved stomach instead of a “pouch” with an artificial stoma; and the quality of life post-op is more like a “normal” person than RNYers get to live. Or at least consider the sleeve, which is as effective as the RNY without as many potential issues. If you have done your research and fully looked into all three, and still are set on the RNY, then I fully support you; I just hate seeing people jump into RNY not knowing that the sleeve and DS exist. I had a DS 11 1/2 years ago, and it was the best thing I ever did for myself. I was 289 with a 51 BMI at the time of surgery; I’m now 157, and fluctuate in a 5-lb range (again, long-term results with DS; the sleeve part helps you lose the weight, the intestinal part helps it stay off after five years, which is when most people regain with the RNY). If interested, check out dsfacts.com, dssurgery.com, duodenalswitch.com. Here is a comparison of the two surgeries: https://www.dsfacts.com/comparison-of-ds-and-rny.php. Here is my rationale for choosing the DS over RNY (I get asked a lot): https://drive.google.com/open?id=17zaUv4zS3E-JptMRBZ8Ir9Wpkl-qyQOkVyymXArk6fg.

    Ignore the other posters who are trying to talk you out of surgery. Surgery is NOT the easy way out, despite what some bystanders think. It is really hard, actually. But it works — for me it was the ONLY way out; no diets (even LCHF, which is basically how I eat now) worked. Regardless of the surgery you choose, I wish you the very best of luck!!!


  12. June 29, 2017 at 9:19 am

    Glad Ireland was a blast!!! I, too, loved it there! And – best of luck with the next journey – which may only be a blast when looking back on it. Love, B


  13. dotkaye
    June 29, 2017 at 11:02 am

    Cathy, I wish you the best of luck.
    The long-term diet seems do-able, though I’d have a lot of trouble with ‘never eat and drink at the same time’ – no more wine with dinner..

    For supplements like multivitamins I like the Primal Blueprint versions, see
    It’s relatively expensive but Mark Sisson who runs the company is a thoughtful guy, used to be head of anti-doping for the ITU (triathlon union) so knows a few things about supplements.
    I’ve taken the Primal Calm supplements with good results. I don’t buy into the whole primal-diet, it’s a bit too much like paleo nonsense, still trust Mark to provide research-based clean supplements that actually contain what it says on the bottle.


  14. July 2, 2017 at 1:57 pm

    I don’t know the specifics of your pre-surgery protein-drink diet but you can make any smoothie taste better (and have more protein!) with peanut powder. We make smoothies all the time with yogurt, peanut powder, bananas, and frozen berries, so no ice is needed. Add/remove/substitute any of the above to meet your specific restrictions but they taste great with no sweeteners added. Good luck and I wish you an uneventful surgery and an easy recovery.


  15. Bob in Van
    July 4, 2017 at 1:51 am

    Cathy, did you watch Dr Lustigs video? I think its “Sugar: the bitter truth”, its not just sugar, though, its corn, HFCS, and all that “food” made in America.

    “We dont know why we’re all fat ..?” – the French arent, the Japanese arent.


    • July 4, 2017 at 3:30 am

      Actually the French and Japanese are increasingly fat too, as are pets, as are non-pets who don’t eat sugar or corn syrup. It’s more complicated.


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