brightfaith

Thank you so much to everyone who replied. I really appreciate it, and I feel much better about pushing back on the low fat guideline and choosing to eat full-fat foods. Thank you again!

Hi all. I had my surgery consult last week and will be doing 6 months of supervised weight management in preparation for the surgery (RNY bypass). The guidelines the nutritionist gave me for eating during this phase included eating 60-80 grams of protein per day and eating low fat. (Low carb was not included as a guideline but avoiding processed carbs, flour, sugar, etc. was.) Could someone let me know the rationale for eating low fat, both during this time period and following the surgery? Up to this point, during periods in which I have been feeling my best, losing significant amounts of weight, and managing my blood sugar levels well (I have type 2 diabetes), I have eaten a whole-foods, low carb diet focusing on eating by hunger and satiety rather than counting calories, and my diet has been high in fat and protein. Not in fried foods and such, being that I wasn't eating things like french fries or breaded foods, but I was eating full-fat cheese or yogurt, for example--whole foods. The fat increased satiety and helped slow the release of glucose. It feels strange to me when I'm focusing on my health to buy non-fat or low-fat versions of foods that may have additives or other ingredients to compensate for the removal of fat, and so I'm struggling a bit. If I better understood why, then I wouldn't struggle quite so much. Is it simply that a gram of fat has more calories that a gram of protein or carbohydrate, and the thinking is that low fat eating will lower calories? Or does fat promote sliding through the pouch? I thought dumping syndrome was more related to sugar/high carb foods, but perhaps I am wrong? Thanks so much for any information!

Had my consult today and this was very helpful. Thank you!

It is so frustrating not to feel progress, especially with something like pain and mobility. But you are well on your way with weight loss, physical therapy, and lifting, and I am hoping your pain eases. Is there an in-person support group near you where you might be able to connect with some new people in similar situations?

Genetics for me also -- my father was more than 550 pounds when he died. I was already big as a toddler, and as a child showed signs of significant insulin resistance (acanthosis nigricans). Starting at about 6 years old, I was on restrictive diet after diet, which threw me into rebellious secret eating by about age 10 and then full blown binge eating disorder shortly after. I was about 260 pounds in my early 20s and then got very depressed and gained about 120 pounds in 18 months. (I'm only 5 feet tall.) I've been stable at about 20 pounds below that, 360 pounds, for years, but my mobility and health are really declining now. Depression really does not help at all. Thankfully, I've finally been on a good combination of medications for depression for the last year, and I believe the improvement in my mood is what has driven me toward the possibility of surgery. I want a more active life than I can lead right now. But binge eating disorder still rears its head, so I have to contend with that as I begin the surgery journey.

I am just in the early phases (having consults with surgeons and beginning the 6-month medically supervised weight management program), but I decided to tell my boss as I knew I would be requesting time out of the office for various appointments. We have a good relationship, she is very supportive, and she agreed to keep it confidential. I trust her, and I am lucky for that. I think you would be fine telling your supervisor you're having a minor procedure--there's no reason you have to go into detail about private medical issues. I also have a very good friend at work, and I've been talking with her about it as well. Other than that, I would prefer not to share with others at work, but I anticipate comments about my food and weight and am dreading dealing with that. Two people in my immediate vicinity talk about food and weight constantly, and even today, one of them loudly announced after walking past my office what I was eating for lunch, giving their approval for it being healthy...thanks, but no thanks, I'd just like to eat in peace.

I also have this question. I spoke with my psychiatrist at my last appointment about the possibility of weight loss surgery, and he said if I decided to move forward, he would work with the surgeon to determine whether any of my medications may pose difficulty, and we could find alternative ways to take them or consider different drugs (which I am loathe to do, because the combination I have been on for the last 18 months is the most effective I have ever taken). Has anyone had to change their medication?