Major weight loss & jaw surgery...new me!

Hong Kong Yanpep International
You're in really solid shape now, but honestly the skin probably won't tighten much more from here. Keep that weight steady for a while and live with it before deciding what's next. I lost over 300 and eventually got plastics, then regained 150 and lost it again - could do another surgery but haven't yet. I know the struggle. Depending where you are, teaching hospitals in the UK might offer cheaper options since they train residents. Medical tourism in other countries is also a thing.
 
bmi charts are based on white dudes only. even thin i was 'overweight.' only time i hit 'healthy' was running myself ragged—full job, college, house reno, babysitting on weekends. looked awful, felt awful. at my best around 160–170 but that's another story.
 
Got down to 176 after stacking compounded tirz and reta - took two and a half years to get here from 325. Now I'm at one milligram of each weekly to hold around 180. Mid-fifties and honestly feeling better than I have in decades. The slow approach worked better than chasing numbers fast.
 
23 lbs before needing to stop and then coming back to it and continuing to respond is useful information - suggests the response didn't reset in a way that would require starting from scratch. How close are you to the final goal at this point?
 
Taking time away post-surgery and then finding food consumption ramping back hard at the end of it - that's the clearest data on what happens when the medication stops. The doc's approach of seeing how you feel first is valid but the hunger returning that strongly is the expected outcome, not a failure of discipline.
 
The post-surgical appetite suppression from the body's healing response is real - the metabolic priority shift toward repair reduces food desire significantly in the first couple of weeks. Getting through the mandatory off period and then coming back to find you still lost weight is one of the more surprising surgical side stories.
 
23 lbs before needing to stop and then jumping back in and continuing to respond is a strong pattern. The jaw surgery context and hitting 45 lbs from goal is such a different frame for this whole thing. Looking great, keep going.
 
the ASA guidance update is meaningful for people planning surgical procedures - the newer protocols are less restrictive about GLP-1 continuation before elective surgery than the older guidance, but implementation is uneven across institutions. if your surgical team is using the more conservative policy, it's worth asking whether they're aware of the updated guidance and what their specific rationale is for their current protocol
 
Started semaglutide a bit over two years postpartum after having one child. Breastfed, and couldn't maintain a calorie deficit without my supply dropping nearly in half, forcing extra pumping sessions just to recover it. Ended up gaining substantial weight back as a result. Was in the 160s pre-pregnancy, hit 204 lbs at delivery, dropped to 173 three weeks later, then climbed to 187 after a full year nursing. Lost 33 lbs on my own without medication and reached 154 lbs, then plateaued for months until I actually climbed back to 169 this past April. Began sema that same April, and thankfully I'm now down 23 lbs sitting at 145. Progress seems to be slowing again on 1.5mg. Would like at minimum another 10 lbs gone, ideally closer to 20-25. But yeah, sema genuinely made a huge difference for me. Finally back to a number I haven't seen since high school. Just hoping I reach my target before running out of room on the titration schedule.
 
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