Honeymoon Period. Calling it a Honeymoon Period is an accurate description. When weight is falling off and suddenly the world is brighter and all is good it is hard to imagine you will ever face the problems of morbid obesity ever again.

Here’s your wake up call. THE WEIGHT LOSS PARTY ENDS. During those first seven months of massive weight loss you are not driving the bus. You will lose the same amount of weight no matter what you do. There are some who don’t catch on to this and happily think that they have somehow cheated the system and are still losing weight while eating french fries. This does not end well in the long run.

It is common for post ops to not lose all the way to goal weight or over the years regain a substantial portion or even all of their weight back if they have not embraced making completely different foods choices. Even those paying attention can get hit with a gain, just like people who have not had weight loss surgery can gain weight. As with most successes, you create a long term plan and follow it. Weight loss surgery is not effortless nor does it last forever without serious commitment to the new way of life you create.

Lozenger1984 welcome to the journey. Just checking in. Did your nutritionist go over an initial plan with you? I found plain Greek yogurt was helpful, I slowly downed 2 a day, I added the protein collagen to my herbal tea, my soups, and puree. Every bit helps. I do not like bariatric shakes of any kind but used the vanilla and added a bit of liquid whey protein which has 47g in 3 oz. Bullet. It's too sweet on it's own. Anyway hope that helps.

WHY DO HORMONAL CHANGES HAPPEN AFTER BARIATRIC SURGERY? It doesn’t matter which procedure you’ve had. Gastric bypass, sleeve gastrectomy and Lap Band surgery can lead to hormonal changes. In a 2012 study published in Science Daily researches found that fertility did not increase but libido (sex drive) increased. When you are overweight your body produces more estrogen. When you lose weight, the estrogen is decreased and the testosterone to estrogen ratio is increased. Testosterone is linked to higher energy and sex drive. A few short months after gastric bypass surgery, A patient experienced menopause. While rare, sudden weight loss can trigger menopause in ‘older’ (late 40’s and 50’ women). Contrary to the cited study, some women claim they got pregnant after weight loss surgery unexpectedly (obesity linked to fertility issues). Whether it’s hormone related or perhaps a patient feels more “body confident” you may find your interest in love making increases rather dramatically.

10-Day Pouch Resetting Guide

On the 1st day, you take only clear liquid diet such as water, broth, tea, coffee sugar-free non-carbonated drink.

On the 2nd and 3rd day, you take full liquid diets such as protein powder with a sugar-free clear liquid, pudding without sugar, soup with soft noodles, non-fat containing yogurt, and sugar-free non-fat ice cream.

On the 4th and 5th day, your diet should be mainly pureed foods. Examples are almond milk, coconut milk, soft cereals, soups, and scrambled eggs.

By the 7th-9th day, you begin to take soft diets such as soft vegetables, soft cereals, soft cheeses, ground beef, soups, scrambled eggs. Others include Mashed fruit (bananas) and canned fruit (with low sugar content).
The above drinks must be taken in small quantity at a time as the excess of them can also overstretch the stomach and prevents the aim of the pouch reset from be achieved.

From the 10th day upward, you can now commence your regular diets with the following precautions

Eat small quantity of food at a time and immediately stop eating once you start feeling the sense of fullness.
Eat slowly and chew thoroughly. Eating too fast allows you swallow gas which can contribute to gastric stretch.
Do not drink water/liquid immediately after food. You either drink 30mins before meal or 30mins after a meal.
Pouch reset is practiced by those who have failed to lose significant weight, following bariatric surgery or those who regained weight after initial losses. This occurs due to a stretched stomach from excessive food intake. Advice from your doctor and dietician as regard your fitness for this intervention is essential to achieve a satisfactory outcome.

Understanding Hair Loss after Bariatric Surgery
By David Kellenberger, MPAS, RD, PA-C

The hair loss associated with bariatric surgery is called telogen effluvium and has to do with the normal hair growth cycle. It usually starts abruptly and very seldom lasts longer than 6 months. Human hair has a two stage growth cycle. The growth phase is called anagen and 90% of our hair follicles are in this phase at any given time. The resting phase is called telogen, which lasts about 1 to 6 months, with an average of 3 months. About 5-15% of our hair is in the resting phase at any given time. It is also known that telogen effluvium has to do with stress to the body and hormonal changes that can occur. Due to the stress more hair follicles can enter into the resting phase. This is important because the hair in the resting phase at the time of surgery is most likely the hair you will shed. This is why your hair sheds between 1 to 6 months after surgery (usually about3 to 4 months). When the hair starts to grow again the old hair follicle is released and you lose hair. Sometimes the hair comes out before new hair grows, yikes!So in summary, this type of hair loss is a diffuse shedding of hair as it relates to the normal hair growth cycle. It is common in men and women and all races. It occurs a little more frequently in women typically after child birth and can also happen to infants after the first month or so of life.

Why does this happen in people who have bariatric surgery? The most common reasons are:
Surgery, acute illness, trauma
Chronic disease such as liver disease or any chronic debilitating disease
Hormonal imbalance such as hypothyroidism
Crash dieting, low protein intake, anorexia, chronic iron deficiency
Heavy metal toxicity
Medications such as beta-blockers, excess vitamin A and anticoagulants (1)
So, what we have here are a few things that may be affecting people with hair loss. It starts with surgery, a very low calorie intake and possibly low protein intake. Then you add any illness along the way, an underactive thyroid, iron deficiency, or genetics and you get hair loss of about 5-15% of your hair follicles. Other nutrients implicated in hair loss include zinc, biotin, folate, vitamin B-6 and essential fatty acids. (2) If no deficiency of these nutrients exists, then they will likely be of little use.

The good news is that you can count on the hair returning unless you have a chronic illness or genetic reason for the hair thinning. The following suggestions are the best advice I can give anyone with telogen effluvium, now that we know what it is.
Relax and don’t worry. It is natural hair loss of 5-15% of your hair due to the stress of surgery and weight loss. It rarely lasts more than 6 months. It grows back. Visit your primary care doctor to be evaluated for any illness or non-nutritional reason for hair loss such as thyroid disease or other chronic illnesses. Follow our dietary prescription which calls for limited calories and exceptional diverse protein intake on a daily basis. DO NOT add a lot of protein and increase your calories so much that you sabotage your weight loss. We suggest a protein supplement that is low in sugar, for our patients we highly recommend BariClear from BariNutrition
Take a bariatric specific multi-vitamin with adequate B vitamins, folate, zinc and biotin. Don’t forget your B12 and calcium citrate with vitamin D supplements.
Avoid excessive vitamin A and high dose zinc supplements they are both potentially harmful.
Add iron if you are iron deficient based on your lab findings in consultation with your healthcare provider.
Consider adding an additional B-complex. The B vitamins are not generally toxic and the extra B vitamins with biotin may help keep your metabolism running smoothly.
Eat fish rich in omega three fatty acids several times a week or supplement with fish oil supplements in consultation with your healthcare provider.
Consider discussing minoxidil drug therapy with your healthcare provider as a possible means to grow or thicken hair. This drug has not been shown to stop the process of telogen effluvium, but given that it stimulates hair growth it may have some benefit.

Based on our findings, a competent surgeon with enough experience can realize the following weight loss numbers for patients.

Average 3 Month Expected Weight Loss 33%
Average 6 Month Expected Weight Loss 50%
Average 12 Month Expected Excess Weight Loss 65%
Average 18 Month Expected Excess Weight Loss 70%
Average Percentage of Excess Weight Loss [Graph]

Here is a site that may prove helpful in determining where you should be or your chances of hitting major weight loss goals within a timeframe. A calculator is provided, enter your data and view 6, 12, 18 months averages. Note that because age, BMI, pre existing health issues may cause you to stall. You doc and nutritionist can help you. I have stalled for 3 weeks... but, let’s face it, I have been on vacation and averaging 1400 calories vs 800. My body is adjusting, I am losing inches, so the scale is not the only measure of success. Take a look.... good stuff.
https://www.obesitycoverage.com/the-complete-patients-guide-to-bariatric-surgery/

Why Do Gastric Bypass Patients Get Sleepy After Eating
Bariatric patients need to make GOOD choices especially at lunch. Tips for NOT crashing after a meal.

Have you noticed since your WLS and return to regular eating a meal often causes you to become sleepy? Seriously sleepy. Drop your head in your plate sleepy.
This happens to me all the time. And there's a good reason for it. When we eat the body produces a rise in blood sugar and a surge in insulin production. This chemical activity sends tryptophan to the brain where it becomes serotonin that signals the body "Take a nap!" Here come the nods, the yawns and the blinking eyes. WLS patients are highly susceptible to post meal sleepiness because of the shortened route to the small intestine. From there the tryptophan has a fast ride to the brain shouting almost like Paul Revere "The Sleepies are coming! The Sleepies are coming!"

Now, I don't want any of you emailing my husband, but quite frequently I dramatically play the "I'm so sleepy" card and go to bed after dinner leaving him with the dishes and evening chores. (Feel free to try this at home!) In fact, he's in the kitchen now doing tonight's dishes!
This is fine for the evening meal, but what about a noonday meal? For example the business lunch. How can we socialize at our mid-day meal and not become a victim of the "Tryptophan Express" to Sleepytown?

A wise nutritional strategy for maintaining a sharp mental edge after lunch is to eat foods that give a gradual, steady release of food energy throughout the afternoon while placing only a light burden on the digestive system. Consider these strategies:
1. Emphasize healthy protein choices, like cold-water fish, beans and legumes, or a non-cream-based main dish soup or stew. Consume 60% of your volume from this group.
2. Choose a minimal serving of low-glycemic-index carbohydrates, like green salad, root vegetables in their skins, mushrooms, green leafy vegetables, broccoli, asparagus, or artichoke. Consume only 20% of your food volume from this group.
3. Be sure your food choices contain healthy fats, such as cold-water fish, flaxseed oil, olive oil vinaigrette (the vinegar helps slow the release of food energy), nuts, seeds, or avocado
4. Absolutely avoid sugary, starchy, or fatty foods like soft drinks, non-whole-grain pasta, fried foods, and rich or creamy sauces and dressings
5. Skip dessert.
Rest assured, (pun intended) by making wise food choices we can be alert, responsive and LivingAfterWLS! Just say no to the Sleepies by making wholesome healthy food choices.
Kaye Bailey © 2005 - All Rights Reserved
Kaye Bailey is a weight loss surgery success story having maintained her health and goal weight for 5+ years. An award winning journalist, she is the author and webmaster of http://www.livingafterwls.com