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What struck me here is not really the macros and much as how different the calories are. The thing is, no calculator is going to tell you what the calorie count should be. My suggestion would be to simply track your existing calories for 1-2 weeks to see where you're at now. I assume your looking to maintain based on the fact you are showing to be at goal. If that's not accurate, then we might need to make some adjustments to what I'm about to propose. At this point, you can completely ignore anything a calculator spits out in terms of calories since by tracking your calories at your current weight, you know exactly where YOU need to be to maintain. Let's say for the sake of making the math easy, you determine that 2000 calories is working for you at maintenance. Skip the calculators and do this: Protein should be somewhere between 1 and 2 grams per kg. If you are inactive, 1 gram is probably minimally sufficient, but if you are very active or shooting for body recomposition, then you need to be closer to 2 grams per kg. 1.5 to 1.6 g/kg might be a good target if you are working out, but not super active, or are not really trying to add any muscle. The next thing to determine is grams of fat. If you are just maintaining, anywhere between 1 and around 1.5 g per kg is probably fine. If you are actively trying to lose or recomp, it would be better to be closer to 0.7 g per kg. Carbs is next and really will just be the rest of your calories, vs. a specific number of grams. Here's how that looks in practice: Again, just to beep the math simple, I'm going to stick with 2000 calories at your current weight of 170lbs, which translates to about 77kg. If your goal is body recomp, then 2g/kg should be your target protein, which equates to 154g per day. 154g at 4 calories per g equals 616 grams from protein per day. Fats when doing a "recomp" would be 77 x 0.7 = 54 grams of fat. 54 grams of fat at 9 calories per gram would be 486 calories from fat If we subtract 616 and 486 from 2000, we'd get 898 calories from carbs. This would be roughly 225 grams of carbs per day. A few notes: This is all based on research, but I also am not "carbophobic". My personal experience is that sufficient carbs are needed to fuel workouts. Some people have success with fewer carbs and more fat. I have no problem with that approach if it work for you. If so, feel free to adjust fat up and carbs down. Either way, the protein is the key, since you'll need that to build muscle. If recomp is not your goal, feel free to run the numbers with lower protein and correspondingly higher fat and carb numbers. Don't go lower than 0.7 g of fat per kg. You need a minimum level of essential fatty acids to stay healthy. In terms of how to change this if you are working out more than you are today, it really comes down to both the types of workouts (endurance sports virtually demand more carbs), but also how vigorous your workouts are. If you are trying to lose weight, I would recommend eating back at least half your calories from your workouts. Any less and you're likely to feel too rundown to put the proper effort into the workouts. If you just skate through workouts, then you lose a lot of the benefit of them. If you are trying to maintain or recomp, then you really should eat back all the calories from your workouts.

HI guys! I am being more strict on my macros till I can work out again, lots of sites and all different outcomes, these are what I have gotten: Macros for Weightloss while not working out: 1838 Calories 167g of Protein 61g Fat 155g Carbs OR 2035 Calories 153g of Protein 79g Fat 178g Carbs Macros for Body Recomposition 2725 Calories 170g Protein 222g Carbs 99g Fat Macros for Weightloss while working out: 2473 Calories 170g Protein 224g Carbs 100g Fat

so tonight I am just having tomato soup, with protein powder and beef stock powder, it's quite nice!😋 I haven't had store bought tomato soup since I was a kid and it was a Sunday night special with bread and or crackers l😂

@bahuber5477 Great job, it sounds like your doing all the right things! I too make an exception for protein shakes. The nutrient profile for most of them is fantastic and for many of us, it would be next to impossible to reach our protein goals eating just whole foods. I know I can't eat that much and I'm over 2 years out. As an aside, I just wanted to say thank you for what you do. Nurses are the unsung heroes of the healthcare system and I for one really appreciate what you all do.

Spartan Maker thanks for the feedback. I am doing my best to increase my physical activity every day. I am weight training with the a trainer 2x a week and I’ve been trying to get in 30-45 minutes of cardio 2-3 times a week to. I do agree I probably need to do my best to up the intensity. I think I’ll start couch to 5k and start jogging. Lately my protein has been variable. I always get 70-80 but I know I would like to get more like 150. On a good day I get 110. My calories have been anywhere from 900-1300 depending on the day and if I work long hours. My hunger is generally fair. I do get hunger cues and what not but it’s not terribly overwhelming. I have been feeling great overall. I would say as far as processed foods the main thing I eat processed is the shakes otherwise I have been trying to eat Whole Foods. I am a nurse and work 12 hour shifts and I do need To do better about getting a little additional physical activity after my shifts. This is a journey but have been blessed with feeling good and generally have good energy.

Sleeved yesterday. Awful pain at first but pain killers and a hot pack helped a lot. Plus sleep! I’ve just been woken up with a tray of Brekky. Bacon, eggs, toast. Nah just kidding it’s yogurt, protein water, Optifast, milk and some sort of juice (I think) . And been told I can get the cannula out of my arm, which drove me mad all night, when I’ve drunk 1litre. Here we go!

Thank you! I have to agree, I noticed when I was making myself eat less, I cannot even work out well, I am lifting lighter or running slower because I am lethargic and fatigued. I do have to admit I am on the straight struggle bus with not being able to work out. I feel like I am eating too much however I am not eating near the calories I was. I do think it has to do with the dietician from my program shaming me into how much I was eating at my 6m appt. She told me that I needed to stick to 800 calories max, 100g protein, 140g carbs and 40g fat. I told her that is just not possible with sustaining my activity. She got into my head and I have been avoiding my 1yr check up for this reason because now I eat even more but I weigh 25lbs less. I wanna be you when I grow up! I was running 15ish miles a week and that was insane to me but 30miles? wow!!! how do you break that up? I would love to do a mini marathon though I am very intimated. I ran 5miles at once ONE time. The next day I couldn't move hahah

Oh my gosh I get this so much!! I get SO cold. My favorite Christmas gift is a heated blanket my Mom got me with two remotes as it is Queen sized - I set that thing on a toasty 118 degrees and will say pulling myself out of that warmth and into the days has been a real struggle! These cold temperatures are absolutely an obstacle for me to want to set foot outside and my joints are all achy. Makes me wish I gad scheduled my surgery for the Spring! I do have an exercise mat and an exercise bike but I have to work around the holiday clutter in the spare room still. Keeping up activity is a true challenge when the cold hurts my face. What warm comfort dishes have you have that are high protein? It's hard not to eyeball the calories vs protein content of things like soup and chilli these days for me.

Sorry, wanted to make one other comment here. Please don't approach your weight loss as something that will inevitably stall short of your goals. Plenty of us make it to goal and below, and have maintained this lower weight successfully. There are two things that will really up your chances here: You need to eat better and move more. If you slowly start making better food choices, you'll find you'll lose weight more steadily and be a lot less likely to regain. By making better food choices, I mean eating less ultra-processed foods and focusing instead on: Protein: High quality legumes Lean dairy Lean meats Carbs: Mostly veggies Some whole grains Some fruit Fats: Try to make this primarily monounsaturated fats This is not to say you can never have a treat, or have to eat only the above, but the more you focus on less processed foods, the better off you'll be. I also recognize that you can't make changes like this overnight. Take your time by just making small changes here and there until they become your new normal. Once those small changes are the new norm for you, it's time to make another small change. Keep at this process of making just small changes and eventually, your diet will be a lot better. In terms of movement, we now have lots of data to show that people that are successful in maintaining after weight loss tend to be very active. Once again, I know you're not going to be running any marathons tomorrow, but you absolutely can start small and focus on doing more and more over time. The CDC recommends at least 150 minutes of moderate intensity physical activity per week, which works out to 30 minutes per day for 5 days. They also recommend 2 days of strength training per week. Some data suggests that formerly overweight and obese people need to do even more than this, so my personal recommendation would be to shoot for at least 300 hours of moderate-intensity physical activity or 150 hours of intense physical activity, or some combination of the two per week. If you are over 65, the CDC also recommends you do some sort of regular training to improve balance since this can have a dramatic impact on fall risk. I know that sounds like a lot, but again, if you start slow (even 5 minutes a day 3 days a week), you definitely can get there. For reference, moderate intensity physical activity is walking a brisk pace, or similar activities such as a slow bike ride. Intense physical activity is more like jogging or riding a bike up a hill. If you didn't work up a sweat, it definitely does not count as intense.

I think you have to first understand what these medicines do. They stimulate insulin production. This may or may not be important to you depending on if you are diabetic. They slow gastric emptying, meaning you'll feel full longer They may suppress hunger signals. Interestingly, researchers don't fully understand why all of this occurs. My personal take in your case is that if you are still steadily losing and are not feeling overly hungry yet (most people don't feel a lot of hunger 4 months post op), then I personally don't see the need to use this medication. I doubt it will do a ton, and might even make it hard to get adequate protein intake. If on the other hand, you are already feeling a lot of hunger and are struggling, then these might help. A few other things to think about: For most people in the US, these medicines can be VERY expensive, even if you have good insurance. If you don't have good insurance, then I hope you're independently wealthy because they can be several thousand dollars a month. Most of the pharmaceutical companies that sell these drugs do have some sort of savings card to make them SIGNIFICANTLY more affordable. Keep in mind that most of those are only good for up to one year. That means you could be back to looking at thousands of dollars a month to continue the medication after the savings card runs out. There are companies that are selling compounded versions of many of the GLP-1 agonists and they sell these for a lot less (typically hundreds of dollars a month rather than thousands). Bariatric Pal is even doing this. These companies can do this because the FDA has special rules for drugs in short supply that allows companies to make them to help fill demand. The issue is that you may or may not be getting what you think. See this link for more info: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss While some companies are certainly reputable and selling you what they say they are, others just are not. It's a little like the wild west right now when it comes to compounded GLP-1 agonists. There is a percentage of people that don't seem to respond to these medications. It's about 15% for semaglutide and a bit less for some of the others. I mention this since some people get really disappointed when this happens, so it would be good to be aware of this possibility ahead of time. These drugs (like most any drug), can have side effects that make then not worth taking for some people. There's really no way to know ahead of time if you will have this sort of problem. Generally speaking, most people that stop using these medicines tend to gain weight back pretty quickly, since the hunger will kick back in. As such, most doctors and pharmacists recommend staying on these for life. It's best to be prepared for this now, vs. thinking you're going to get away with just taking it temporarily.

I was sleeved in 2016. Lost weight, but no where near goal. Gained it all back. I just had a revision to a bypass this week (Jan 13). Things are going fine, almost too fine. Minimal discomfort, I have no problem keeping fluids or protein down. I am eating about 600 calories per day with 80 grams of protein. I’m not hungry. (I am on a 3 week liquid diet post op at the moment.) I also haven’t lost any weight. Does this sound normal?

Maybe check out Dr. Matthew Weiner’s pound of cure weight loss book. He goes over a handful of things that you can change and you can pick which one you want to start with. For me, the fruits and veggies was a good one because I actually like fruits and veggies. Replacing a lot of the process carbs with healthy carbs for me is the most important component to weight loss not just to cut calories in the short run but to stop cravings in the long run. For me processed carbs, make me crave sugar. One cookie and I want pasta I want cake. I want it all and I crave it for a week. Natural carbs do not do that to me and they can help reduce the cravings a little while I get through the week or so to detox from them. Once I am off of the processed carbs so long as I get my protein, I stay feeling full so it’s much easier to sustain a healthy diet. Keto never worked for me either and I have learned post surgery that is most likely because of not being able to eat hardly any carbs at or it was all the processed junk I was eating instead of natural food. They alter things by adding more fiber to cut the carbs and all of that and that may be reducing your calories to help you lose weight, but for me it wasn’t the same for my body as a veggie with fiber. It’s not sustainable because my body was still craving the carbs. I would lose weight in the beginning, but the cravings were horrible and eventually I would give in to them and then I just wanted even more. Anyways, you may not be able to replace every unhealthy carb with healthy carbs on your own before surgery, but if you can reduce some of them by trying out different recipes to find fruits and veggies that you like, it may cut enough to lose your 10% and be a good start to finding healthy carbs that you enjoy

A hernia seems really unlikely if it doesn't hurt. To me it sounds more like a keloid, but I agree that the best option is to ask your doctor about it.

Hopefully it gets better with time but they do make ginger candies that could help with nausea. Also maybe try protein shakes and see if you can stomach them better since they don’t need to be digested as much as they can be sipped slowly over time. Maybe just pop them back in the cooler ir pour over ice.

The time has come in my journey where I have had a little weight gain - about 3lbs in 10 days. I know it is to be expected it is just a little frustrating! For reference, my typical day of eating includes some protein porridge for breakfast, a sandwich or a salad with some chicken/avocado for lunch, some soy marinated boiled eggs as a snack, and then for dinner is usually some form of meat for protein, some veg and some carbs (I'll eat the veg/protein first). I try to aim for 2.5L of water a day - usually manage anywhere from 1.5-2L if I am honest! I do drink tea & coffee, and I go to the gym 3-4 times a week, mostly doing a range of weight training, and also 20-30 mins of cardio: my go to cardio at the moment is on the treadmill, on a 12 incline, speed at 4.8-6 and walking for a set amount of time. ANYWAY - just feeling a little disheartened!!

That’s awesome. I have been very pleased with my revision to SADI. My surgeon didn’t mention the intestine length thing but he did have me do the barium swallow, an endoscopy and a gastric emptying study before saying that the SADI would be an option as well as the bypass and it was up to me which I wanted to do. There are pros and cons to the SADI revision. statistically (which by definition means there are outliers that are more or less) but the majority of people lose faster and the loss is more durable which got my attention but the possibility of bathroom issues is significant (fortunately I didn’t have this at all until I recently started chemo but I don’t think it has anything to do with the surgery). One con though of SADI is that many doctors have never heard of it. From my family Dr, to the urgent care, ER physicians, gyno, radiologies, breast surgeon, etc. Even the gastro dr who will be doing an endoscopy and colonoscopy on me Monday has never heard of the SADI but my bariatric doctor said he will explain my anatomy to her and it will be fine. I always tell them it’s a modified version of the Duodenal Switch with one anastomosis instead of two and if they still look confused I tell them it’s not exactly but kinda like a bypass and a sleeve combined. But obviously I need the person putting a camera in there to understand better than that. I think you will be very pleased with your results from either one but another thing to consider is if you have a complication or need revision to the SADI how many doctors are able to operate on you. My surgeon told me that if I had a complication he would stabilize me but he would send me to a nearby hospital if I needed any type of revision. I appreciated that he was willing to admit his limits and I was okay with that but I guess it is a risk you may want to ask about. Your surgeon may very well have done lots of these but mine had not. Also, not a lot of doctors will do a revision to the SADI just because of regain. You would be more likely to find someone to revise a bypass. Not that we are hoping to need a third surgery but obesity is complex and a lifelong struggle so it’s something to think about. I wish you the best of luck. And hope to hear about your surgery date soon.

Thank you so much for your response. It’s perfect timing that I saw this as I just left the Bariatric surgeon’s office. My experience with GLP-1s was quite discouraging. I was just about ready to give up trying to lose the weight I regained. However, my appointment with the Bariatric surgeon was quite encouraging. He agrees that I qualify for a revision surgery. He laid out the revision surgery options: Bypass, SADI-S or SIPS. Apparently the final revision surgery method will be determined during the surgery when he is able to assess my intestine length for the bypass/malabsorption effect. So for now, I’m going to focus on completing the program steps (Barium swallow, Psych appointment, Nutrition appt, support group, etc) so they can submit the PA for revision surgery. So I’m going to focus on completing the insurance requirements

My advice is to make changes to your diet and exercise in the next few months that you feel you can maintain for the rest of your life, as opposed to trying a fad diet (Keto, paleo, etc.) that is likely to be too extreme. Focus on basics like reducing your simple carbs and sugars, increasing your lean protein and veggies. Start measuring your portions to make sure you are not eating more than you think. Start getting your 64oz or more of water every day and cut out any sugar-sweetened drinks that you might drink (and also alcohol) because it's just empty calories. Walking and light weights are really great, but remember that about 80% of your weight loss comes from your diet, and only 20% from exercise, so don't feel like you have to go crazy with joining a gym and working out, especially if you're starting from sedentary. Regular walking every day does amazing things. At this stage, small changes can make a big difference. One thing I did right away was go through my cupboards and get rid of temptations. I stopped buying crackers, pretzels, cookies, and sweets. I would still have a treat when I was out, but I would try not to bring it home. Since I work from home, not having things in the cupboards to tempt me was a huge help. I was not required to lose weight before my surgery, but by making these little changes, plus the strict 2-week liquid diet, I ended up going from 251 lbs to 225 lbs in about 6 months. You can do it!

I'm on day 3 of my pre-op liquid diet. My surgery date is the 30th. Three protein shakes a day, and I can blend fruit (apple and/or berries) with some protein powder for a smoothie and also non-starch veggies for pureed soup. No sugar, no carbs, no dairy. Thank goodness for my Magic Bullet and immersion blender! It's going okay so far. My cravings are all head hunger because the liquid diet is keeping me full. I'm also having doubts every day. I know I need to do this because whatever I lose, I will just gain back and then some. I've lost 60 lbs. over and over again for the last 15 years. I can never keep it off. So, this surgery isn't necessarily to help me lose as I know I can do that on my own, but to help me maintain loss and keep it off for good. There are so many things I love that I am looking forward to doing, things my weight has been preventing for most of my adult life. Shopping "normal" sizes, traveling, socializing, horseback riding. I just need to focus on my long-term goals.

Great idea to speak with your bariatric doctor but discuss the Wegovy with them as well. I have not discussed Wegovy with the bariatric surgeon post surgery but I mentioned it to the PA as a possibility if I am to gain during my cancer treatment over this year if that would be an option and he say it may. I mean he could have assumed that I just meant any GLP-1 and assumed either would do but he didn’t say that Wegovy was not okay for me and I had sleeve prior to my revision to SADI and my surgeon leaves the sleeve as is and does the bypass portion to make up the modified duodenal switch surgery (SADI). Also, post sleeve but pre SADI, I discussed GLP-1 as an option for regain and he said it was a serious contender in terms of what he thought would work for me but the insurance coverage was the issue. I went with the revision and it’s been night and day In terms of the surgery being a better fit for me so I’m not trying to deter you, but maybe the redo was all I needed because I wasn’t mentally ready with the sleeve. I guess I honestly can’t say 100% for certain. Either way, don’t give up. The bariatric doctors won’t give up on you either, together you will find what works for you. Consider what your coverage is and what the cost will be long term though and whether your team will keep prescribing it as a maintenance thing or what happens when you get to goal too because there are pros and cons with both. I mean Wegovy is not surgery and that’s a pro anytime you can avoid surgery but the cost, long term side effects of the shot and regain stats are all things that I would be asking about.

Thank you! I think I have all those loss of nutrients and certainly lower protein.

I went from an 18E at about 200lbs to a 10E at 108lbs. I remember I was a 12F/G at 132lbs. (Bought a few new bras as I thought yay goal. I didn’t even get to wear all of them before they were too big. Sigh!). I wish they were a little smaller in the cup as I still have trouble getting fitted tops and dress to go around them at times. You know buttons gaping and trouble doing up side zips the last 2 or 3 inches. Yes, your frame will influence what size looks better on your body. Friend had a reduction to a 14C 2 yrs ago. She has a large frame and was about a size 18/20 Aust dress size & 18E bra. I felt they looked too small on her broader frame and size. Now she’s on Wegovy and losing weight so her smaller boobs should start to be more balanced I think. But I do agree with the suggestion to err on the side of going a littler smaller. Padded and push up bras can make a noticeable difference if needed. And it’s easier to find a wider range of prettier bra styles & options. Plus if you’re active, it’s easier to find more comfortable sports bras if you’re a smaller cup size than those large cup overs that feel like you’re all bound up & restricted.

Thank you! Yeah, spreading it out does seem to help a bit, or literally 'eating' the meds with something that barely needs chewed, like yogurt or cottage cheese. The three I am supposed to take in the morning are Prilosec, Strattera, and Chantix. Something about those three together is a recipe for ick and I'm not sure why. I wish I could ditch the Chantix but to keep from relapsing into smoking I don't dare yet. I've already slipped up a few times on the smoking; have to really focus on redirecting myself after eating to keep from lighting up while my food settles. I thankfully don't have issues with my chewable vitamins and do space my Calcium out at least three hours from my multi with iron; I mainly need to focus on mindfulness regarding all of my intake. I am glad my relationship with food is getting better though! I don't completely restrict myself from any food but just keep in mind how the food will make me feel. WIN: I'm definitely getting better about noting the difference between brain hunger and physical hunger and reach for a protein before a salty carb to sate cravings!

I do totally understand the sister sizes, but thank you. That is my concern that if I were to go with a D now at 36 that if I do actually get down to a 32, which is what size I was when I was 25 so technically I guess it is possible, that I would be a triple D or F depending on the brand and where it’s made and if I recall correctly 32F was one of the harder sizes to find. I am just tired of having to go to one store that is almost always out of stock and have very limited options for bras. So I’m thinking maybe I should go with a C to be safe. That is true that I can always wear a padded bra or even one of them water bras if I just had a certain outfit that I wanted to be a little bigger in. I never thought of that.

Hey congrats! I wanted to let you know while I myself haven't been through this surgery, my mom has had it. She said it doesn't hurt as bad as you'd think. Plus they are pretty good about giving you what you need to be comfy med wise. I will be having mine the 14th of next month, and I'm pretty nervous too. I think the biggest thing is going to be sticking to directions. Making sure not to drink during meals, waiting for so long before and after, getting in enough water or protein. But I think it will go well, please keep us updated on how it goes for you ❤️ You've got this!