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Hello, I am new here and don't know where or how to post things to ask the Dietician - but here is my story and I need help please. I had Laparoscopic Sleeve Gastrectomy August 6th, 2019. My surgeon and nutritionist said being almost 2 years out of surgery, my stomach should be able to hold 8 ounces in volume or 1 cup of food at a time (but obviously if I get full, don’t eat the whole thing) When I first started this journey, I had the Laparoscopic Sleeve Gastrectomy on August 6th, 2019, they said only eat 4 ounces of food for a meal three times a day. I did that and weighed my food at 4 ounces on my kitchen scale. Then a year and a half out they tell me no, I need to go by VOLUME and not by weight or else I will stretch my stomach! I feel like I am limited in what I can eat now because how do I make a sandwich fit in a measuring cup or a piece of pizza (which I no isn’t nutritious..) but just using those as an example for size. In addition to the whole volume thing, what about foods that expand like breads and crackers and pasta? How do I measure their volume? If I figure out the volume of something like that should I take away some of the food item that will expand, so I do not go over the volume? For example: If I make a sandwich that is a perfect half cup in volume, should I remove some of the bread because if it expands it will be more that that half of cup? I hope that makes sense. I have lost 230lbs since August 2019. Now I have to learn how to reeat again, because I don’t know how to measure volume without putting it into a measuring cup. I find conversion calculators online, but they give me different answers. I thought, well if my kitchen scale says 4oz in weight am I able to find the fl oz of that without smushing it? I don’t know what is accurate? Weighing was so much easier, but now I am told volume and that it has to fit into a measuring cup, but how do you put a meal in a measuring cup? Right now, I eat 3 meals a day at 1/3 cup volume measuring cup per meal and with 1 – 2 protein shakes for the day in between my meals. I eat a meal at around 6am, 12 – 1pm, and around 6 – 6:30pm. I get full on only a few bites of my 1/3 cup food or what I think fullness is so I don’t always finish even that. My hunger signals and fullness signals are all screwed up. And I don't know if it is all in my head? Thank you so much for your time. I truly appreciate it. I try asking my nutritionist and surgeon these things and they say they don’t know how to answer them – just make sure you don’t stretch your sleeve and go over the volume! I try to stay at 1/3cup volume per meal, because I am afraid of stretching my stomach out now. Maybe one day I can go up to 8 ounces in volume I hope because my meal choices have become really restricted because I can’t mush them into a measuring cup and what I can doesn’t seem worth it because If I wanted to enjoy a little something sweet, it barely fits in the 1/3cup – so why bother. Then that makes me sad. I originally weighed 352lbs and now I am 119lbs. I also spoke to someone who said that after I lose all of my weight that it doesn’t matter if I overeat and stretch my stomach back out any more just as long as I stay within 1,200 calories, 120 carbs, and 90g of protein? Is that true? My hunger and fullness signals are really difficult for me to tell apart and I have a severe anxiety over stretching my stomach (that I am trying to seek help for). But if the whole “It doesn’t matter if your stomach stretches back to normal” is fine and I watch my nutrition, is that ok? I feel like that would be giving up and taking the easy way out because I “like food more than blah, blah, blah, and just want to eat..” I am afraid of going back to old habits because I love bread and sweets. It scares me to gain any of my weight back because I don’t want to be one of those where people say, look at her – you can’t even tell she had weight loss surgery because she gained it all back! I made this big decision, this massive life change and accomplished a great weight loss, but now am I giving it all up? All because I miss food and want to eat in between meals. Right now I am so hungry or head hungry, but not physically hungry, but head hungry enough I think I want to eat something. I need help tp get on track and figure some things out please? I don’t know what else to do and I am so utterly lost. My surgeon tells me to ask my dietician these questions because he doesn’t know how to answer them – he just preforms the surgery. My dietician told me to go by weight, then volume and now she’s telling me not to weigh or measure at all just to go by how I am feeling? Well sometimes I feel I can eat a lot. I am not getting the support from them I need and I just need someone to have patience and understanding and who is kind to work with me please. I am sorry if this is a lot of information to take in. I don’t mean to go on a rant. I am just so confused. I am going to see a therapist, but the whole stretching my stomach thing is a real fear. I also had complications after surgery with bleeding that I am told may have given me PTDS..

This right here

I think at this point, you need to develop a more common sense approach to this. It sounds like you know what you should not be eating and need to focus on what you can eat and track that as accurately as possible. I am attaching my Boot Camp document again...which in the final stage says to eat three 4 oz high protein meals, plus two servings of vegetables, two servings of fruit and three servings of complex carbs. Get a tracker like My Fitness Pal and track your intake. I do NOT think you need to "smoosh" things into a measuring cup, you should be able to "eyeball" a cup or quarter cup of food, or weigh it. Good luck and I hope you can find something that works for you! Post Op Diet Boot Camp.pdf

Excited for you! It's nuts looking forward to something like this, isn't it?

Hi Elaine, welcome. The doctor is just gonna talk with you about your weight, your dieting history, what the surgery is like, what to expect from the surgery & help you decide which surgery is right for you. If you have acid reflux at all you should have a RNY. From what I’ve seen in the boards, your age isn’t a concern at all. Toodles, Rue

Bariatric Breakfast—Protein Pancakes Bariatric vanilla protein low carbohydrate pancakes recipe Ingredients Yields: Four 4 pancakes Serving size: 2 pancakes 2 scoops BariNutrics™ Vanilla Protein 1 tsp. baking powder 1 pinch salt 2 Tbsp. unsweetened almond milk, milk, or water 2 large eggs, beaten Directions Prep Time: 5 minutes In a medium-sized bowl, combine first three ingredients. In a small bowl, beat eggs and add milk. Add eggs and milk mixture to dry ingredients and mix until completely combined. Heat skillet or electric fry pan to medium. Once hot, add ¼ cup of pancake mix. Cook on first side for 3 minutes. Flip and cook 1 additional minute.

I have also been ravenous since my surgery last Monday, but I can't stomach the sweetness of the protein shakes anymore so I've been having skim milk and water or crystal light. @Creekimp13 thank you for your explanation - many people have told me it was head hunger, but I didn't believe it was because I would literally eat a boiled unseasoned chicken breast right now if I could.

He could have said that in another way. I think it is sooo great that you are walking. It speaks volumes to how seriously you are taking this lifestyle change. I think maaaaybe the doctor was trying to say it’s 80% diet and 20% exercise and wants you to make the diet a priority? I’m not sure, but in any case.. KEEP UP THE GREAT WORK

I agree walking is good for your health for many reasons. You can lose most of your excess body weight by following a good nutrition plan with no exercise. Exercise will improve other aspects of your health. There are healthy overweight people and unhealthy people of average weight.

Thank you. I left feeling pretty bummed.