Eating After Gastric Sleeve Surgery

How Will Bariatric Procedures Affect Your Eating Habits?

With readily available junk food and superbly busy lifestyles – not to mention the superstore grocery centres that sell your favorite foods in bulk – it is increasingly more difficult to lose weight AND keep it off.

To make the situation of weight gain worse, many of us do not begin to realise we are steadily putting on a lot more weight until quite late in the ‘cycle’ of gaining.  It seems that suddenly nothing in our wardrobe fits us anymore, including our largest size slacks.

We look at the scale and panic.



Wanting to let go of the excess weight as quickly as we can goes through our minds.

IF not our own minds, then the minds of our General Practitioners or Endocrinologist, who may remind us of the detrimental health repercussions of being overweight.

Why is being over weight such a common issue in Australia society?

The answer is many reasons, but all intertwined.  Firstly, we live busier than ever lives, including working far too many hours or running the kids around from event to event. Then there’s the sugar-laden soft drinks and junk-food/fast-food availability on every corner. With fast food chains and snack manufacturers using secret ingredients and lots of sugar into tricking our minds into wanting MORE MORE MORE, it’s no wonder there’s a national epidemic of obesity at our door.

With the newest ‘weight loss’ medication still years away from being workable with no side effects, it can be a tough go to lose the excess weight once it’s solidly distributed around, and on, your body frame.

As we all know, it’s not nearly as easy to lose weight as it is to gain weight. Plus, our busy lifestyles and eating habits aren’t exactly helping.

Once we get to a certain super-sized, unhealthy Body Mass Index (BMI), we can also find that our joints don’t safely allow our bodies to exercise without pain or risk to our ligaments and joints.


Weight Loss Tips

Why some people need Gastric Bands or Gastric Sleeve Surgery

Some people with certain genes and eating habits really struggle to be able to lose weight after they become severely overweight or even morbidly obese.  (Anyone with a BMI of over 29.9/30 is considered obese and over 35 is considered Morbidly Obese.)

So despite exercising and eating as healthily as they can – no amount of dieting seems to help these individuals lose the excess weight.

They’ve also likely gotten to the stage that their intake capacity (stomach size) is able to consume far more calories than they could ever hope to burn off through activity or normal metabolism functions – no matter how much or how long they exercised.


Obesity is Dangerous but Gastric Surgery including Gastric Sleeve Operations can be life saving

We all know that living with obesity is dangerous to health and longevity, but we also recognise that dieting adversely impacts our health and often leads to further weight gain when we go back to eating normally, due to extreme diets impacts on our organs and our metabolism.

Even if temporarily successful, extreme diets are also unlikely to keep the weight off of your body over a longer period of time.  In such a scenario where your weight, BMI and your waist measurements are at a dangerous HIGH – your GP or Endocrinologist or Surgeon may recommend weight loss surgery.

The more common weight loss surgeries (known as Bariatric Surgery) include the Gastric Sleeve, the Gastric Band, a Gastric Bypass procedure or a Lap Band procedure.

What is a Gastric Sleeve Surgery?

vector illustration of vertical sleeve gastrectomy vsg

  • A gastric sleeve surgery involves reducing the size of your stomach
  • This helps you lose weight by limiting how much food you can comfortably and safely consume.
  • After your stomach is reduced, your appetite is also reduced, which can help you better control your eating or food cravings (but not totally – you’ll still need to do a lot of work and maintain a very different lifestyle to keep your results and get healthy – it just might give you a bit more help than if you tried to do so without the surgery).
  • With a reduced stomach size, you’ll feel fuller, faster too -which often helps reduce your food intake and reduces your everyday calorie consumption.

Gastric Sleeve Surgery is gaining as an effective option for helping obese or severely overweight people to lose weight and overcome obesity.


Unlike the lap band, no adjustments are needed with a Gastric Sleeve Procedure.

Gastric Details

Plus, it appears that you’ll be able to lose more weight with a Gastric Sleeve procedure compared to a Lap Band or a Gastric Bypass.

Pre-operative Gastric Sleeve Diet

If you choose to have this surgery, your Specialist Bariatric Surgeon (Obesity Surgery Specialist) will give you details. He or she will also advise you of the potential complications and risks of having this surgery, as well as special dietary measures you’ll need to take to maintain results and overall health.

You are likely be advised by your Bariatric Surgeon to undertake special eating habits to shrink the size of your liver before surgery. That’s because an enlarged liver can increase the complications in your surgery.  Eating differently BEFORE your Gastric Sleeve Surgery not only helps to leave you healthier, it also helps you prepare for an altered diet that you will need to adhere to AFTER your gastric surgery procedure.

gastric surgery gastric band

In your pre-surgery and post-surgery Gastric Band eating plan, you’ll likely be told to consume a bit more protein and less carbohydrates than your normal eating regime.

  • You are likely to be asked to eliminate added sugars (avoid drinking soft drinks)
  • This change alone can help you lose a bit of weight and re-adjust your appetite.
  • You must also drink lots of liquids and keep hydrated (plain water or water with real lemon juice is typically a great option)
  • Your may be advised to undergo a strictly liquid diet at least two days prior to your surgery day.
  • Your Bariatric Surgeon and Care Team will give you specific instructions for the months, weeks and days before your surgery.
  • Planning and adapting to your gastric sleeve can take more time and energy than you may initially realise
  • So if you’re considering this option, be sure to book a consultation with your chosen Bariatric Surgeon as soon as you know you’re wanting the surgery to best prepare yourself for a Gastric Sleeve.

Eating Choices after Gastric Sleeve Surgery

In the time following your gastric sleeve surgery, you’ll need to take utmost care of your eating routines and follow YOUR Surgeon’s specific advise (most Surgeons will also link you up with a nutritional counselor).

Week One after Gastric Sleeve – what can you eat?

The information below is of a general nature and is not intended as advice. NOR is it a substitute for the medical information and pre and post-op recommendations provided to you by your GP and your Gastric Surgeon. 

In general, if you’re about to have Gastric Sleeve surgery, here’s what to expect (with modifications as per your Surgeon or particular health needs).

Week 1 After Gastric Sleeve Surgery (Intake Clear Liquids Only)

water after gastric sleeve surgery

  • In the first week after your gastric sleeve surgery, you may be allowed to take in ONLY clear liquids such as water, fresh juices, soups and broths.
  • Avoid any carbonated beverages or other drinks with added sugars.
  • Typically, you’ll be advised to take small sips, and to take these liquids in very slowly.
  • You WON’T be able to eat fruits and vegetables although you might be able to squeeze fresh fruit juice into your water – ask your Surgeon (no pulp though typically)!
  • Decaffeinated tea and coffee are usually okay soon after Surgery
  • Check with your Surgeon as they might NOT be permitted for you or in relation to your specific procedure.
  • Once you’re readily able to tolerate liquids, your Surgeon will advise you when you can advance to the next stage of eating changes (pureed foods).

Week 2 After Gastric Sleeve Surgery: Pureed Foods


  • During the second week, you may typically take in foods in their pureed form.
  • These may include mashed potatoes, low-fat cottage cheese, sugar-free yogurt, soup with blenderized vegetables and hot watery oatmeal.
  • Ask what pureed vegetables you are – or aren’t – allowed to have.
  • You might be tempted to overdo it – but don’t. It’s not worth the risk and can get very uncomfortable very quickly if you eat the wrong foods, or too much of the right ones, after surgery.

Week 3 After Gastric Surgery: Soft Foods and Protein Shakes

  • In week 3, you might be able take protein shakes about once a day.
  • You might be approved to also eat hummus, steamed or boiled vegetables, soft cereals, scrambled eggs, mashed fruits, steamed fish, ground chicken with stock and soups.
  • Avoid starchy foods like rice, pasta and bread.
  • Vegetables that are fibrous – like broccoli, celery and asparagus – should definitely be avoided.

Week 4 After Gastric Sleeve Surgery: Some Solid Meals

  • In week 4, your eating regime may begin to allow you to eat some ‘solid’ meals.
  • You can typically begin eating restricted fruits, sweet potatoes, baked potatoes, cereals, fish and chicken.
  • Avoid eating fried foods, lollies, whole milk and nuts – these are not easy to digest.
  • During week 5, you may even have one or two healthy snacks in-between your normal meal times.
  • A hard-boiled egg, hummus, bananas or soft rice crackers might be okay options for you (ask your Surgeon and Nutritionist for details).

The most important thing that needs to be kept in mind after Gastric Band surgery is that your meals should be nutrient-dense (nutritionally valuable) as well as remain sparse in calories. You know what that means – good foods, not junk foods!


How Long Before I see Weight Loss Results after Gastric Sleeve Surgery?

In the months AFTER your surgery, you’ll also have specific eating recommendations from your Surgical team, and you’ll need to monitor your eating regime and portion control.

It is often reported that patients can start seeing great results just a few weeks after their gastric surgery procedures.

On average, patients might lose around 60% of their pre-surgery weight.

weight loss concept blue male

What about your skin after Gastric Sleeve surgery – will it bounce back?

Gastric sleeve surgery and other bariatric surgeries often leaves you with baggy skin, or Redundant Skin.  You can’t exercise skin – it’s over stretched and will only tighten up a bit to a certain point. So the skin, along with any stubborn stores of fat after the major weight is lost, may still end up needing to be surgically removed. Liposuction and tummy tuck surgeries (including Belt Lipectomy Procedures) are also quite common after bariatric surgery procedures.

If you need your redundant skin removed, Dr Maxwell offers many various Body Contouring procedures such as Tummy Tucks, Belt Lipectomy and Upper Arm Reduction/Arm Lift and Thigh Reduction surgeries.

If after you have adopted your new healthy lifestyle and have done nearly everything you can to see results – and you remain unhappy with the body shape outcome after approximately 18 months to up to 4 years, you might also want to consider Body Contouring and Liposuction options with  Specialist Plastic Surgeon Mr Richard Maxwell.

Dr Maxwell

Dr Maxwell is a Specialist Plastic Surgeons who focuses on patients who have lost massive amounts of weight via Gastric Sleeve or Gastric Banding procedures.  He also helps people who have lost a lot of weight through major life style changes alone (yet not everyone succeeds in overcoming obesity permanently without surgical assistance). He also offers Face Lifts, Tummy Tuck/Abdominoplasty procedures, Breast Lifts, Breast Reductions and Arm Reductions/Thigh Reductions as well as Belt Lipectomy (Circumferential Abdominoplasty) procedures to help bring the body back into its normal contours.

If you’ve already lost the weight after gastric surgery or lifestyle changes (or both) and want to reduce redundant skin, phone us today on (03) 8849 1467 to schedule a consultation with Dr Maxwell in Hawthorn or Williamstown.

For more information on Bariatric Surgery and Surgeons in Australia who can perform Gastric Sleeve or related Bariatric procedures, visit or send us an enquiry form below.

Gastric sleeve surgery diet and nutrition


For more information or to see our BEFORE & AFTER photos of patients who have had body contouring surgery after weight loss, send an enquiry below or give us a call during Clinic Hours on (03) 8849 1467

Cooking up weight loss! MasterChef's fitness fanatic contestant Nicole Stevenson to create recipe book for gastric sleeve surgery patients Read more: Follow us: @MailOnline on Twitter | DailyMail on Facebook


She made it into MasterChef’s coveted top 24 chefs.

And Nicole Stevenson’s aspirations for greatness doesn’t end in the kitchen, the 24-year-old telling OK! Magazine she plans to use her cooking ability for good.

The medical secretary from Ipswich, Queensland, plans to create a recipe book for gastric sleeve surgery patients once the show wraps up.

Cooking up some good! MasterChef's fitness fanatic contestant Nicole Stevenson plans to create recipe book for gastric sleeve surgery patients

Cooking up some good! MasterChef’s fitness fanatic contestant Nicole Stevenson plans to create recipe book for gastric sleeve surgery patients

Nicole told the publication she thought up the plan through her work as a medical secretary for the past half decade.

‘I worked at a weight-loss surgery for five years and came up with an idea to create a cookbook, with the advice of a nutritionist, to help those who have just had gastric sleeve surgery,’ she explained.

The bubbly blonde is a self-confessed fitness fanatic who hopes to use her cooking skills to get others to be more healthy.

Making plans: Nicole told the publication she thought up the plan through her work as a medical secretary for the past half decade

Making plans: Nicole told the publication she thought up the plan through her work as a medical secretary for the past half decade.

Pete sent home from MasterChef after plating up messy meal

‘I know food is what I want to do and no matter what, I’ll follow my passion,’ Nicole said.

 Growing up in a close family, Nicole learnt cooking from her Dutch Oma and mother.

The blonde’s favourite cuisines to cook include Vietnamese, Mexican and Italian dishes.

Wants to inspire others: The bubbly blonde is a self-confessed fitness fanatic who hopes to use her cooking skills to get others to be more healthy

Loves exercise! Outside of the kitchen she is a fitness fanatic, completing a solo trek in Nepal aged 21

Loves exercise! Outside of the kitchen she is a fitness fanatic, completing a solo trek in Nepal aged 21

Benjamin is eliminated from MasterChef after burning fruity dessert

Outside of the kitchen she is a fitness fanatic, completing a solo trek in Nepal aged 21.

Meanwhile competition on MasterChef is heating up, with the green team facing an elimination challenge on Thursday night.

The group had struggled to create a feast of appetizing vegetable-only meals for meat eaters on Wednesday night’s episode.

Getting tougher: Meanwhile competition on MasterChef is heating up, with the green team facing an elimination challenge on Thursday night

Getting tougher: Meanwhile competition on MasterChef is heating up, with the green team facing an elimination challenge on Thursday night

'I could barely go up a flight of stairs': How surgery helped her lose 150 pounds

Gastric bypass surgery linked to problems with alcohol

atest study shows weight loss surgery may lead patients developing alcohol abuse problem.

Jinger Jarrett

Jinger Jarrett

CBS News on Twitter: "Popular weight-loss surgery linked to ... -

Bariatric surgery is a lifesaver for many patients who have it because it allows them to lose weight and keep it off after having tried all other methods. A new study was published recently that showed that not all the side effects of gastric bypass surgery are good. One side effect that patients who have the surgery may suffer from is a substance abuse problem.

Gastric bypass patients risk having an alcohol problem

Yahoo News reported that the latest #Weight Loss Surgery study was published in the journal Surgery for Obesity and Related Diseases. The latest findings in this new study discovered that one in five patients who have gastric bypass surgery will develop a problem with alcohol.

Researchers also discovered that patients who had the gastric bypass procedure were twice as likely to develop a problem with alcohol as those who had the laparoscopic adjustable gastric banding procedure. While the gastric bypass procedure makes the patient’s stomach smaller, the laparoscopic adjustable gastric banding procedure creates a small pouch to contain food eaten by patients.

Details of the gastric bypass surgery

The study, conducted by researchers at the University of Pittsburgh Schools of the Health Sciences, studied 2,348 patients who underwent the gastric bypass surgery. CBS News reported that the study was conducted over a period of seven years. Researchers said that they noticed that some patients experienced problems within the first two years of having surgery. What researchers didn’t expect to happen though was that the number of patients who were experiencing problems with alcohol actually went up the longer it had been after the surgery.

How to combat risk of developing an alcohol problem

Researchers recommended that doctors take a full history of patients and to ask if the patient has had Bariatric surgery. It is important that doctors ask patients who have had the procedure whether they have experienced problems with alcohol and also how much they drink. In a study done by animal researchers, the researchers believed that having the gastric bypass surgery may also affect how the brain processes reward sensitivity and that patients who are sensitive to alcohol would more likely be affected. Scientists recommend screening, education, and evaluation to discover which patients are the most vulnerable.

Researchers said that the findings were important because alcohol affects patients’ ability to maintain weight loss and #Alcohol Abuse can lead to vitamin deficiencies. Developing a personalized weight loss plan is key to success when trying to lose weight. The latest weight loss procedure, endoscopic sleeve gastroplasty, may offer a safer and more effective alternative for patients because it is nonsurgical.

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Can Weight Loss Surgery Kill You? Facts, Myths And Everything Else You Need To Know


As more than one-third or 36.5 percent of the adults in the United States have obesity, many think of getting a weight loss surgery. But, is the procedure safe?Image result for man belly

Weight loss surgery has a 99.9 percent survival rate and the long-term risks of remaining obese is much greater than the risks of weight loss surgery. One in 10 patients usually experience minor to serious complications as a result of weigh loss surgery.

After comparing obesity statistics in the country from 1999 to 2000 – in which adult obesity only accounted for 30.5 percent – to those from 2013 to 2014, the Centers for Disease Control determined obesity rates had increased significantly.

Read: How To Control Obesity? More Homecooked Meals

Before delving deeper into the facts and myths of weight loss surgery, below are the risks and complications that obese adults usually face.

While being overweight refers to an excess amount of body weight that may come from muscles, bone, fat, and water, obesity refers to an excess amount of body fat. According to World Health Organisation’s fact sheet, worldwide obesity has nearly doubled since 1980. Nearly 44 percent of the diabetes burden, 23 percent of ischaemic heart diseases and between seven and 41 percent of certain cancer burdens are attributable to overweight and obesity.

Obesity can cause the following conditions:

1. Heart Disease and Stroke: Extra weight can make you more vulnerable to high blood pressure and high cholesterol, both of which can cause heart disease or stroke. According to several studies, losing a small amount of the extra weight could lower the chance of developing heart disease.

2. Type 2 Diabetes: This is mostly caused due to being overweight or obese and can be controlled by losing weight, a balanced diet, getting adequate sleep, and exercising more.

3. Cancer: Several studies have found links between obesity and cancer in the colon, breasts (after menopause), endometrium (the lining of the uterus), kidneys, and esophagus. There are also links between obesity and cancers to the gallbladder, ovaries, and pancreas.

4. Gallbladder Disease: You are more prone to gallbladder disease and gallstones if you are overweight.

5. Osteoarthritis: You can develop this joint condition that most often affects the knee, hip, or back, if you are overweight or obese.

6. Gout: Another disease related to joints is linked to obesity as it is most commonly seen in overweight people.

7. Sleep Apnea: A breathing condition, which can cause a person to snore heavily and to briefly stop breathing during sleep, has been linked to being overweight. Weight loss often improves sleep apnea.

While there are several ways to tackle obesity, such as physical activities and consumption of fruits and vegitables, the fastest way of reducing extra fat is believed to be weight loss surgery.

There are four types of weight loss surgery typically used by surgeons.

1. Gastric Bypass: Also known as the “Roux-en-Y” gastric bypass, or RYGB, this method will require a surgeon to leave only a very small part of the stomach (called the pouch) where the food you consume gets stored after bypassing the rest of the stomach. This surgery can often be done through several small incisions using a camera to see inside (laparoscope).

2. Adjustable Gastric Band: During this procedure, the surgeon puts a small band around the top of the stomach. The band limits how much food can go into your stomach. This surgery is done using a laparoscope. Gastric banding is also less likely to cause nutritional problems.

3. Gastric Sleeve: This surgery removes most of the stomach and leaves only a narrow section of the upper part of the stomach, called a gastric sleeve. Following this surgery, the hunger hormone ghrelin is released in less amount, so you eat less.

4. Duodenal Switch: This is a complicated surgery that removes most of the stomach and uses a gastric sleeve to bypass most of your small intestine. It limits how much you can eat.

The most common surgery practice is the gastric bypass surgery. Following this surgery, people typically stay in the hospital for 2 to 3 days and return to normal activity within 2 to 3 weeks. Minor complications that affect about 10 percent of people include, wound infections, digestive problems, ulcers, bleeding etc.

Upto 5 percent of people face serious or life-threatening complications, such as blood clot (pulmonary embolism), heart attack, leak in the surgical connections with the intestines, and serious infection or bleeding.

Deaths in the month following gastric bypass surgery are very rare when the procedure is done by a highly experienced surgeon.

EXCLUSIVE: Abby Lee Miller on Why She's Having Gastric Sleeve Surgery Just Weeks Before Prison Sentencing

by Zach Seemayer


Former Dance Moms star Abby Lee Miller is waiting to receive sentencing on fraud charges, but that’s not keeping her from going under the knife to get gastric sleeve surgery before she possibly goes to prison.

Speaking with ET’s Cameron Mathison recently, Miller revealed why she decided to undergo the operation during this already trying period in her life.

“I think this is the right time,” Miller explained. “People are saying, ‘But your sentencing is coming up in a couple weeks!’ And that is true, and I’m really nervous about that — more than the surgery — but there’s no right time.”

WATCH: Abby Lee Miller Breaks Down Before New Surgery: ‘Nobody’s Freaking Out If Something Happens to Me’

According to Miller, she feels that her tumultuous circumstances are actually a message from the universe.

“Maybe this is some miraculous way somebody’s telling me, ‘Hey go for it, do it now so that whatever happens, maybe you’ll be a little bit healthier, maybe you’ll be a little bit more in shape.’ Who knows?” Miller, who was operated on by Dr. Michael Russo at the Smart Dimensions Surgical Center in Newport Beach, California, shared.

The reality star claims that she tried several times to eat healthier and stick to a socially conscious diet while filming Dance Moms, but said that she got no support from the production.

WATCH: Abby Lee Miller’s Biggest Revelations: From ‘Dance Moms’ & ‘Dancing With the Stars’ Drama to Prison & Dating

“I try to be vegan… I really, really try. I don’t eat any red meat and the whole animal thing really upsets me so I’ve tried,” she explained. “But even on the TV show, they would laugh in my face.”

“They wouldn’t care if I was trying to be vegan, they wouldn’t get a special vegan meal or anything,” she continued. “They just laughed and would hand me a hoagie sandwich or Italian sub from somewhere.”

The dance instructor said it’s because of behavior like this that she has no interest in going back to work on the Lifetime docuseries.

“I’ve just had it. I’ve had it with the lack of respect,” Miller, 50, continued. “[In their eyes] I’m still some Podunk dance teacher from Pittsburgh that they saved and that’s not who I ever was. That’s not who I am. It’s not that I’ve changed,it’s just they never realized it.”

Lifetime had no comment on Miller’s accusations.

WATCH: ‘Dance Moms’ Star Abby Lee Miller on Pending Fraud Case Sentencing: ‘Maybe I Need a Few Months’ Vacation’

That doesn’t mean she wouldn’t like to return to reality TV, however. Miller said she’s “been to some meetings” recently that could lead to some new opportunities.

“I found myself in a room full of people and actually, these big time execs are trying to sell themselves to me! It’s usually the other way around,” she said. “It’s been quite exciting.”

Miller also said that she hasn’t totally closed the door on Dance Moms either, but that some big changes would need to be implemented before she’d consider it.

“I would love to go back, but it would have to change,” Miller shared. “There has to be a sense of respect. There has to be a creative credit.”

WATCH: Abby Lee Miller on Cheryl Burke Taking Over ‘Dance Moms’: ‘I Bet You She’s Treated Differently’

Tune in to ET on Monday for our full interview with Miller. Check your local listings here.

For more on Miller’s sleeve gastrectomy operation, check out the video below.

cretid to :Zach Seemayer

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Stress sent Maribel Contreras' weight soaring, but her competitive spirit helped her lose 77 pounds.


Maribel Contreras, 38, 5’6″
El Monte, Calif.
Before: 217 lb., size 16
After: 140 lb., size 6

Total pounds lost: 77
Total sizes lost: 5

My whole life, I was a yo-yo dieter. I would restrict calories to drop weight, only to binge-eat and put it back on. In 2009, after giving birth to twins, I left a job I loved to move to San Gabriel Valley, Calif., and soon turned soda and Doritos to cope with all the stress. In July, 2013, my poor eating habits and lack of movement finally caught up with me; I hit an all-time high of 217 pounds, more than what I weighed while pregnant. Then my doctor told me I was prediabetic; I knew I had to make a change.

RELATED: I Did It! Weight-Loss Success Stories

A lifesaving move
Later that month, I joined an online weight-loss support group. After some persuading from friends on the site, I scheduled gastric sleeve surgery. While the operation promised to control my eating and make pounds melt off, I was unable to keep the horror stories I had read about the surgery from flashing in my head. I canceled the procedure the night before it was supposed to happen. My weight wasn’t something surgery could fix, anyway—I needed to adjust my attitude. The next day, I joined Gold’s Gym and started working with a trainer three times a week.

Routine, revamped!
I exercised regularly and lost a little more than 20 pounds in a year and a half. But I was still usually choosing cheesy quesadillas over more nutritious stuff. So I decided to register for a 12-week body transformation contest at my gym. In addition to revving up my workouts, I swapped out my typical fast-food meals for healthier options, such as grilled chicken and eggs. By the end of the three months, I had not only shed 47 pounds but also won the entire challenge! Knowing that I had transformed my body was the greatest prize of all.

RELATED: This is the Last Diet You’ll Ever Need

Secrets of a 77-pound loser:
Maribel learned a few secrets along the way. Now she uses them to stay on track.

Pick a power playlist
Starting off my workouts with pump-me-up songs like “Shake It Off” by Taylor Swift keeps me motivated throughout the session.

Find a mantra
On days when I want to give up, I repeat these words: “I’m very strong; I can do this.” Just saying the sentence out loud stops me from feeling weak.

Tech it out
My Microsoft Band ($250; helps me maintain my fitness goals. It lets me log my exercise and calorie burn to make sure I’m hitting my targets.

Broadcast your goals
When I joined the challenge, I told everyone about my plan to win. The fear of losing and having to admit to all my friends that I failed kept me going.

As told to Lindsey Murray

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Overweight boy refused gastric sleeve surgery in hospital system failing, surgeon says

AN 11-year-old boy who tipped the scales at 130kg was refused weight-loss surgery in a case his surgeon says highlights problems in the hospital system.

The child was so big he was unable to attend school.

Leading gastrointestinal surgeon Dr George Hopkins said the system was not yet prepared to deal with the realities of the obesity epidemic.

Dr Hopkins urged all health workers to pressure hospitals and administrators into allowing younger morbidly obese children to undergo the radical operations.

The Queensland surgeon said the system failed the child.

“It was literally gut-wrenching. He wasn’t there because of diabetes … this kid was unable to attend school at age 11 and his mother took him out to homeschool him until he had surgery,” Dr Hopkins said.

“This kid refused point blank because it was not worth it. He could learn nothing in the environment created.

The overweight boy (not pictured) was too obese to attend school.

“His mother said ‘what are we waiting for?’.

“I made the argument that it was the youngest I had ever considered doing, but there was an argument to be had (for surgery).

“All clinicians directly involved in this kid’s case agreed it needed to be done — myself, Eric (the anaesthetist) a paediatric surgeon, his paediatrician, and there were two paediatric opinions given — but the hospitals said no.”


Having already performed a successful gastric sleeve operation on the boy’s older brother when he was 15, Dr Hopkins had to wait until the boy turned 13 to perform the surgery.

Addressing the Australian and New Zealand College of Anaesthetists annual conference in Brisbane, Dr Hopkins said traditional interventions such as diet and exercise do not work and, when there was consensus among specialists in individual cases, a child’s age should not be a barrier to surgery.

With a quarter of Australian primary school children overweight or obese, Dr Hopkins explained that there was a “tsunami” approaching hospital administrators, but he believes improved outcomes and future health system savings justified offering gastric sleeves to younger patients.

The gastric sleeve procedure pays for itself in other health savings down the track, a top surgeon says. Picture: iStock

While the surgery costs about $5000, and up to $250,000 if there is a complication from the operation, Dr Hopkins said the results paid for themselves in other health savings within three years.

“The fact we are trying so hard to insist these kids get treated with a measure we categorically already know doesn’t work, is perverse,” he said.

“Once we start this program, if we were to start such a program, we would simply have health economists and bureaucrats frozen in their tracks with the potential of the volume.

“The youngsters that we have done have responded so well that when we start to expect them … If we can get these people during puberty we might have a better long-term outcome than if we wait until they are 20-25.”

While hospitals have been afraid of opening up weight loss surgery to young patients for fear of dangerous complications, Dr Hopkins said risks applied to all types of medical interventions and the benefits of gastric sleeves far outweighed the chances of something going wrong.

“The biggest dilemma we have in the adolescent paediatric (area) is that sooner or later you are going to hurt someone,” he said.

“We do need to have a discussion in this room as well as in the medical community at large, that we do have a fairly safe and reproducible option for these incredibly sick sad kids — but it is going to take a little bit of pushing by the clinicians involved.”

BODIES Model Reveals Gastric Sleeve Surgery to Lose 240 Lbs. and Calls Skin Removal 'The Most Painful Journey of My Entire Life'


Rosie Mercado had reached a high weight of 410 lbs. when she was told by an airline employee that she needed to purchase a second seat to fit on the plane.

The embarrassing incident was an ‘aha’ moment for the mom-of-three, who decided she needed to lose weight, and successfully dropped to 300 lbs. through diet and exercise alone over the course of a year and a half.

Then, she reached a standstill, and even began putting on weight again.

“As soon as I hit 320, I was like, no I cannot go back to being 410,” Mercado, 36, tells PEOPLE. “I was going back and forth with my weight, and I saw a documentary on the [gastric] sleeve. I said, ‘You know what I’m going to do this. It’s the next part of my journey.’ ”

The curvy model said the real work came after having her surgery done.

“I don’t think you could be prepared for the work that has to be done psychologically,” she says, noting that she had to completely eliminate soda, dessert, pasta and rice from her diet, or else she felt extremely ill.

“Anything that bloats just completely went away,” she says. “You start really educating yourself on eating healthy, eating lean and eating really small portions. You go out with friends and you order an appetizer and eat half of that, and you sit there waiting for everyone else. It psychologically plays with your mind.”


It took Mercado a while to get used to her new lifestyle and her new body.“You have to deal with being low-calorie, and deal with the adjustment to your body as you’re dropping weight,” she says. “You learn what you’re allowed to do and what you’re not allowed to do. If you do what you’re not allowed to do, you’re going to feel like crap.”

Choosing to get gastric sleeve surgery was a “tough decision,” says Mercado. “It’s not an easy walk. Surgery is just a tool. It’s not guaranteed success. Success comes from the discipline – it forces you to wake up and pay attention to what you’re eating. It’s a lifestyle.”

Mercado got the surgery to get healthy – not to be super thin.

“There’s no goal for me to be a size 6,” she says. “I just want to be healthy and fit. Being obese is putting your life at risk every single day.”

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Thanks to her surgery and dedication to a healthy lifestyle, Mercado lost over 200 lbs. – which led to a new problem. Mercado had 20 lbs. of excess skin on her stomach, which led to rashes, pain and general discomfort.

“I had to be in Spanx the entire time,” she says. “I couldn’t run without Spanx because of the weight of the skin. You lose all this weight, you’re excited, and then you take your clothes off and you have all this excess skin. New issues start coming up.”

So Mercado decided to get skin removal surgery, getting a full tummy tuck to reconstruct her abdomen.

“That has been by far the most painful journey of my entire life,” she says. “It was burning, aching, tubes coming everywhere.”

Even though it was a long and painful process, she has no regrets.

“I would do it all over again because I am able to wear clothes that I was never able to wear, I can run and I don’t feel the pulling of my skin, I’m not dealing with the skin rashes,” she says.

Now, Mercado has lost a total of 240 lbs., bringing her from a size 36 to a size 12/14.

“I’m not perfect, I’ve still got cellulite, but it’s a huge improvement to the problems I was dealing with,” she says. “I’m able to do so many more things. My confidence comes, not just from the way that I look, but from the freedom that I have.”

She remains committed to a healthy lifestyle to maintain her goal weight. Mercado goes to boot camp classes three days a week, and runs and walks three other days a week. She sticks to a diet of lean protein, vegetables and fish, and avoids sugar.

And she doesn’t really care if other people disapprove of her choices.

“I’ve already gotten slammed for losing weight,” says Mercado. “Everybody says, ‘You’re no longer plus size.’ If you compare size 12/14 to a size 36, I don’t look plus size, but I’m still plus size, I still have curves. At the end of the day, it’s your body and [you should do what] makes you feel better.”

Gastric bypass poses concerning risk for alcohol problems, study says

Gastric bypass poses concerning risk for alcohol problems, study says

Wendy C. King, Ph.D., epidemiologist, University of Pittsburgh Graduate School of Public Health.

Digging deeper than previous research, a study that followed weight-loss surgery patients over seven years found those who had Roux-en-Y gastric bypass had twice the risk of developing “alcohol use disorder” than those who had gastric banding instead.

More than 2,000 patients from 10 hospitals and six clinics were questioned about their addictive behaviors in the study, published recently in the journal Surgery for Obesity and Related Diseases. Bariatric professionals have expressed concern that some patients who had no problems with alcohol were developing them after bypass surgery, either for the first time or as a relapse. The definition of alcohol use disorder — in the updated Diagnostical and Statistical Manual of Mental Health Disorders (DSM-5) — ranges from mild problems with drinking to the most severe cases of alcoholism.

“I don’t think this should dissuade people from getting surgery … if someone feels they’re a good surgical candidate,” said the study’s lead author, epidemiologist Wendy C. King, Ph.D., of the University of Pittsburgh Graduate School of Public Health. “I would caution them against alcohol consumption — or [suggest] close monitoring.”

Bariatric surgery is considered the most effective treatment for severe obesity, usually defined as a body mass index of 40 or higher. The surgery can improve a patient’s other serious health conditions, including Type 2 diabetes, Ms. King pointed out.

In the Roux-en-Y, a small part of the stomach is used to make a pouch and this smaller stomach is connected directly to the middle part of the small intestine, bypassing the rest of the stomach and the upper part of the small intestine. It’s less space where nutrients are absorbed, which makes it different than laparoscopic adjustable gastric banding. Lap banding creates a smaller stomach with a thin, inflatable ring wrapped around the upper portion of the stomach.

In results reported in 2012 from the National Institutes of Health-funded study, alcohol use disorder was found to be more prevalent in the second year after surgery than in the first year or beforehand. The study found the Roux-en-Y “doubled the likelihood of postoperative AUD compared to [lap banding].”

In the seven-year follow-up, Ms. King said, “We wanted to look at those who didn’t have problems in the year before surgery. We found that within five years of surgery, about 1 in 5 patients who underwent Roux-en-Y had symptoms [of alcohol use disorder]. Only 1 in 10 had the symptoms following banding. This is accumulative incidence. If they report it year after year, it counted. The Incidence kept climbing.”

Patients were questioned about their alcohol drinking habits with a 10-question survey about drink amounts, frequency and behavior such as whether a person is able to stop drinking, if drinking has caused a failure to meet expectations or if it caused feelings of remorse. Participants were also asked if they used illicit drugs (except opioids) or had received counseling or hospital treatment in the past 12 months, including treatment for alcohol/​drug abuse.

The first round of questions and assessments was before surgery. Annual follow-ups ended Jan. 31, 2017. Although gastric sleeve surgery is now the most common bariatric surgery, it was not in 2006 when the study first recruited participants and was not included in the comparison.

Before surgery, 97 out of 1,469 (6.6 percent) in the Roux-en-Y group had some alcohol use disorder symptoms; 36 out of 519 (6.9 percent) in the banding group reported symptoms.

By the fifth year, the cumulative reports of alcohol use disorder, illicit drug use and substance use treatment rose to 20.8 percent, 7.5 percent and 3.5 percent, respectively, for the Roux group. In the banding group, the reports were 11.3 percent, alcohol use disorder; 4.9 percent, illicit drug use; and .9 percent, substance use treatment. Alcohol consumption doubled in the seven years after both types of surgery, the study reported.

Factors associated with a greater risk of developing alcohol use disorder and illicit drug use after surgery were “males and younger adults and those who smoke and who reported consuming alcohol regularly,” Ms. King said, “also those with less social support.”

Two “addictive” behaviors — binge eating and out-of-control eating — have been cited as related to the observed higher alcohol consumption. However, the long-term study found food-addiction behaviors were not associated with substance use disorder (alcohol and/​or drug use) that was reported after surgeries.

A co-investigator in the study until he left UPMC in 2013, Allegheny Health Network bariatric surgeon George M. Eid said there have been two theories about alcohol problems after surgery.

“Some think it’s food addiction … that when you do bariatric surgery you’re trading one addiction for another.”

He said studies have shown after bypass, alcohol is absorbed at a higher level and faster and patients say they feel its effects more.

“Some data says the effect of one glass before surgery feels like four glasses after surgery,” Dr. Eid said. Drinking more in both groups in the seven-year study supports the theory that some patients enjoy the effects of drinking and some are feeling more social after weight loss, he said.

“In my opinion, it’s multifactorial — absorption, more social openness.”

Reduced nutrient absorption because of the bypass may also be a factor, said research psychologist Melissa A. Kalarchian, Ph.D., a co-author of the follow-up study and now at Duquesne University. Binge eating before surgery and amount of weight loss were not related to substance use after, she said.

The study recommends that future research explore post-surgery changes in the endocrine system, possibly involving the appetite-related hormone ghrelin, as a risk factor for substance use disorder.

Since the earlier research that found the risk was higher after Roux-en-Y, the American Society for Bariatric Surgery has recommended screening before surgery and making patients aware of the risk. High-risk groups are advised to abstain from drinking alcohol after the bypass surgery.

“This recent study [concerns] anybody who undergoes Roux-en-Y bypass,” Ms. King said. “I would advocate for stronger recommendation for abstaining, for anyone who gets a Roux-en-Y bypass. We need the word to go out to primary care physicians. Those doctors really have to know how to screen.” And if treatment is needed, to recommend it, she added.

Study authors cited the size and diversity of the groups of patients studied and the length of the follow-up — gathering detailed data — as its strengths.

“I think this is one of the largest, most comprehensive studies to date,” Ms. Kalarchian said. Among limitations of the study are the comparison with the outdated banding method, she said, and patients weren’t given full clinical evaluations — the study relied on patients’ own reports of alcohol and drug use.

The increase in alcohol consumption in both surgery groups is a concern, Ms. King said. “It may affect weight loss, dumping syndrome [food passing too rapidly through the stomach] and vitamin deficiency. Those are all concerns with heavy drinking. Because we have more people drinking regularly … we strongly support a routine assessment for alcohol use disorder.”

Dr. Eid said long-term followup is recommended as part of the AHN bariatric surgery program. He said obesity experts worldwide are concluding that obesity is a chronic relapsing disease and it calls for continuing care.