PRE-OP WEIGHT LOSS...Giving Up VENT!

I am really thinking of doing that. Thanks. I am going to e-mail my doctor ASAP. :)

 I have failed miserably in the past trying to lose weight by only watching my calories.  My pre-op diet was between 800-1000 calories and no more than 60 carbs a day.  Make your calories count by getting in as much protein as you can.  This included trying out some different protein shakes.  I am a "lightweight" so I didn't have as much as some people have to lose but in my one month pre-op diet, I lost almost 20 pounds.  I was very dilligent and did not sway from the diet at all.   I concur on seeing a therapist.  I still do.  Good luck.  I hope it all works out for you.  :)

 Is it your surgeon's requirement or your insurance companies?  I would check and if the insurance company doesn't have that requirement I would find another surgeon.  To me that is unreasonable to ask someone who is unable to control their diet without surgery to control their diet without surgery.

Some surgeons won't operate because they see your failure to lose the weight as a sign that you will not be compliant after surgery or are not motivated enough.

If your surgeon does not have a dietician on board, something is wrong. You need that professional to learn how to eat post-op. They are the only ones licensed by the state who can do that professionally.

If you concentrate on protein, you will lose weight. That is the whole basis behind the pre-op liquid diet. You have to not just count all calories, you have to weigh all your food. You may be taking in more calories than you realize.

If you are taking in even one glass of milk more everyday (or it's calorie equivalent) than your body needs, in one year you can put on 10 pounds or more. Multiply that by the years you have been heavy and see what you get.

Don't forget calories from tasting while cooking, drinks, etc. My program's director says time and time again when somebody makes an appointment to come in because they are gaining, she has them keep a diary. The either call to cancel or show up to tell her they figured out the problem once they were writing down what they ate.
Watch the salt, too. You should not have pitting edema.

Fortunately, the research states that pre-op difficulty has no relationship to post-op success. However, post-op difficulty, like not following the given plan, is associated with failure.

The reason we need this surgery is because diets don't work for us.  If you (we) could lose weight by dieting,  we wouldn't need the surgery. DUH!  I do not understand the insurance or physician requirement to lose weight first.  On my 3 month supervised diet I broke even at best.  I think I gained a little. My insurance company had no weight loss requirement.  

 My surgeon required a 6-week liquid diet (Optifast) prior to surgery to shrink the liver.  I lost 30 lbs those 6 weeks.  I was thrilled,  the surgeon and staff were thrilled. 

Good luck.

Are you in an HMO rather than a PPO so that you must get a referral to get to another surgeon?  If so can you check out the surgeons in your area that are in network and contact their office to see what their requirements are?  I question how much your PCP knows about WLS. Many surgeons do not require that patients lose weight prior to surgery unless they have high BMIs.  Those who are super morbidly obese or border on it are often required to lose weight in order to shrink the liver prior to surgery.

I would never have been able to lose a substantial amount of weight prior to surgery.  I did lose 11 lbs in the 5 months prior to surgery by cutting back on diet cokes and limiting portions.

I hope you can get a referral to another surgeon who will be more sensitive to the probleems of the morbidly obese.

Hi,

First off let me say that I can totally relate. It is really difficult for me to lose weight under "normal" cir****tances or as normal as they get ;-).

My surgeon has me on a 2-week preop diet (my wls is next week) but he didn't say I had to lose a specific amount of weight. I had gone to a different surgeon prior though that had wanted me to lose 1% of excess body weight or something like that so they are all very different. I never heard of a surgeon not submitting paperwork to insurance though until you hit a specific weight so that is strange.

I did an extremely intensive weight loss program 2 years ago and lost 72 lbs in 7 months. Losing the weight was very hard but maintaining it was even harder so now that I've gained back almost all of it (long story), I'm getting gastric bypass.

You should obviously consult with your PCP or nutritionist but here's what my 2-week preop diet is in addition to taking 2 multivitamins and B12 daily:

Daily calories are approx 800-1000 (you should definitely consult your dr b/c this may be too low for you)
2-3 protein shakes (breakfast, lunch, optional afternoon snack)
Small meal for dinner that should consist of the following:
   4 oz lean meat
   1 starch serving (1/2 cup or 1oz)
   2 vegetable servings (1/2 cup cooked or 1 cup raw = 1 serving)
   1 fruit serving (1 medium piece of fruit or 4oz fruit juice or 1/4 cup dried fruit = 1 serving)
   1 fat serving (1 tbsp regular dressing or 2 tbsp light dressing = 1 serving)

But I'm being even stricter than what is recommended because I have PCOS so even if I go on a low calorie diet, my weight loss is suboptimal unless I go low-carb. I'm drinking low-carb EAS protein shakes and the Atkins ones too. For dinner I'm only eating non-starchy vegetables and minimal fruit for carbs.

Also, I learned that stress and/or not getting enough sleep hinders weight loss. I don't know if you ever noticed that if you stay up all night and weigh yourself at your normal time, you probably haven't lost any weight whereas typically I go down 1-2 lbs overnight. Exercising will help relieve some of your stress but you'll need to find other ways to manage that. I know you have a baby (not sure how old) so try to get as much sleep consistently as you can at night. It really does make a difference.

Good luck! I know this is tough but keep trying. I hope my info helped :-).
  

This diet sounds fantastic. I think the issue is that my bmi is really high, I want to say 45. I am 5' 8" and my weight is 303 but when I first saw my surgeon it was 292. I get paid tomorrow so I think I just might buy some protein shakes or snacks for in between because the snacks get to me, I never really know what to eat. All of your info really helped me! Thank you so much :)

Hang in there and just keep going, no matter what! I really can relate to your frustration. I had to lose 30 pounds pre-op and then my surgeon tells me I also have a two week liquid diet to follow. I had already been doing a liquid diet to get the weight off! I ate one meal a day and drank the rest and it worked, but I was (am) starving! My understanding is that the weight loss helps shrink the liver which they have to move out of the way during surgery. For whatever reason, it is hard and feels like it takes forever, but you can do it! It is also very stressful, so do what you can to take care of yourself!