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Have a look at Dr Matthew Weiner’s Pound of Cure website and podcasts. He has excellent information, books (incl the metabolic reset diet) and online nutrition classes you can sign up for. They also have support groups you may find helpful too. Personally, I wouldn’t go back to the pre surgical shake diet. (I’m with you, those shakes are disgusting.) Instead go back to how you were eating once your weight initially stabilised. That calorie load was appropriate for the weight you were so will be a deficit for what you are consuming now therefore weight loss will occur Focus of your protein goals eating protein first then vegetables and finally any complex carbs as you are able. Ensure you’re getting your fluids in. Aim for lowish carbs, low sugar (real, artificial or alternatives), lower fats & add a little fruit. Check your portions, try to eat regularly & watch snacking. Track your intake even from now so you can see where you may need to make adjustments. You can start slowly by focussing on one modifying one or two aspect s at a time then two or so weeks later add another change.

Hi, my name is Krislynn, Kris, or just K., I'm new to this forum. I found it researching more about the duodenal switch. I turned 42 in July this year, and my highest weight before my first surgery was 536. I had the gastric sleeve in June 2017. The first year was a great learning experience in learning about healthy foods, changing my mindset, and what I needed to do to get healthy. That first year, I lost 221 lbs. But, then when I went back for the 2-year check-up, the surgeon that took care of me, had left the hospital and program and they informed me they had no one for me to see. But, then Covid hit shortly after that-- then I lost my job and ended up sitting home 2 years and gained close to 200 lbs back of what I lost and that was crippling to me because all my old health problems came right back. during all this happening, my mom and I chose to move from California to Indiana to be closer to my sister, I decided I couldn't take care of my mom who has declining health because of her weight too, has been type 2 diabetic for more than 20+ years at this rate with my health starting to decline again too. So I reached out to the weight loss doctors here, I spent 6 months Feb-Aug '24 taking off 70+ lbs by following their 1200 calorie diet, getting back into a healthy mindset. It's a struggle at times, and sometimes I take two big steps forward, and then I end up taking a big step backward, it's a daily walk. once I completed the mandatory 6-month medical weigh-ins, things moved quickly, I got approved by the psychologist, and then the insurance approved me to have the Duodenal Switch or SADIS surgery quickly, within a week I heard back. My new surgeon who's great, got me scheduled quickly after I finished all the required testing, and preop classes, this Monday, the 11th at 7 AM. I am feeling nervous because even though every test they've made me do has come back normal and negative, I am 7 years older and worry that something might possibly happen. I keep reminding myself, that I've already had the sleeve, so I won't be under that long, just long enough for him to do the switch. so basically, I'm going to go to sleep and then wake up on the other side of it. Can anyone who has had this surgery, give some advice or maybe just let me what to expect after this kind of surgery? The last time I woke up the only thing I remember is the immense pressure I felt on my chest from them feeling my stomach with gas to do the surgery. And The surgeon told me unfortunately I would be dealing with that again because it's something unavoidable. So, I'm prepared for that. Love to everyone, Krislynn☺️💜

it took me 4 months (and ~15 lbs) to figure out my maintenance calories were. i also had to get over my fear of gaining all my weight back and actually start eating MORE. maintenance level calories are VERY individual, and vary greatly from person to person. and even then, it varies greatly form time to time for the SAME person. 4-ish months after achieving goal, i finally figured out that i needed 1800 cals a day to stop losing weight... AT THAT TIME. over the years, this amount has changed depending on my activity level. luckily, i am anal and i track my food intake and weight DAILY so i am armed with data to figure out what i need at any point in time. i am 6 years post op now, and these days i need about 2300-2500 to maintain my current weight (i exercise alot). had i continued to stay at 1800 cals from the before days i would have shrunk beyond what i wanted. soooooo....long story short: your maintenance calories will change depending on your output and input, on your sleep patterns, overall health, stress levels, age, genetics, etc....its up to you to notice what affects you and act upon it. so, so, so, so, many times i read folks on here saying "i gained/lost weight and i just don't know why!". the answer is PAY ATTENTION....you will know why. P.S. i do know that "normal" people don't need this level of attention to stay at a healthy weight. i also know that i am NOT a "normal" person. i mean, i got to a BMI of 43 (from BMI 23), in 10 years. it takes more "effort" for me to stay at a healthy weight that a "regular" person. so i do what i am willing to do.

as others have touched on above, it depends on what you call a "normal sized meal". can i eat my "normal sized" pre-wls meal from my obesity heyday? hecks no. but, let's be real, those meals were bigger (and not as often-consumed) as the meal sizes of not-obese people. now...can i eat enough food to maintain my current weight, feel satisfied AND not feel like i'm depriving myself? yecks, YEAH. from the outside and to those not in the know, it probably looks like i don't eat enough, but its enough for ME. my restriction is still very much in effect, so i don't eat alot in VOLUME at one sitting. but i did* manage to get my 2300+ calories in by eating often, and choosing higher calorie foods. (NOTE: i exercise ALOT, so my caloric needs are probably higher for your average 5'2" person, but still) *clarification (and to go off on tangent): i WAS able to do this, but lately am not eating as often - for other reasons** - so my average calorie count has been dropping, but i'm working on it.... ** i got braces and my pure HATRED and annoyance of having to clean my teeth after eating ANYTHING has effectively stopped me from eating. it's in my head, i know. i'm working on it....

I wish I could say from experience but I never made it to the maintenance phase with my sleeve and I’m early out from my revision. From being on the boards though it seems what most people do is to add like 100 healthy calories at a time and wait and see if that makes them gain and keep upping it until they find what their body is happy with. Of course if you level of activity or type of calories changes you may have to adjust so I think if you don’t choose to log your food daily you may want to at least spot check it like once a week just so you can see if your habits change gradually and keep on track for what works for your body. Congratulations on nearing maintenance!!

Everyone is different. I am almost 6 years out. I made it to my goal weight about 1 1/2 years after surgery using the Fast Metabolism Diet for the last 6 months of that. I went back up 15 pounds but my body is happy here. I have never thought about calories. I have always concentrated on how many ounces I eat at a meal. I never go above 3.5oz total. 2oz protein & 1.5oz. I also eat 5 times a day. 3 meals & 2 snacks like cheese or fruit. You have to figure out what works best for you.

Nope there’s no normal. You have to work out what you need in regards to nutrients and calories to maintain & your body to function effectively. Gender, height, age, weight, activity levels, how your body functions, etc. all play are part. For example 2000-2400 calories is the recommended calorie intake for a woman. If I ate that I’d be as big or bigger than I was before surgery. In fact I never ate that much when I was obese. When my weight first stabilised I ate about 1300 calories yet a year or two later I began consuming about 1600 & still maintained - my needs obviously changed or stabilised. If I weighed more, was taller, younger, more active I would need to eat more. As to working out what I needed, I just slowly ate more as I was able until I stopped losing and my weight stabilised. A basal metabolic rate calculator can give you an idea of what you may need calorie wise but much like BMI calculators they’re not perfect - don’t consider genetics, health needs, muscle mass, etc. I found the one below pretty on point for me but … https://www.calculator.net/bmr-calculator.html

Exactly as others have reacted. What is your definition of a normal size? I can eat about a recommended portion size and that took me well into my 3rd year. Sometimes it depends on what I’m eating or if I’m feeling hungry & then I can’t eat the whole portion. Not unusual to have leftovers in my fridge. As an example I can eat about 3ozs of protein plus a cup of vegetables for dinner, 2 golf ball size rissoles/meat balls & cup of vegetables, about 2/3 of 2 scrambled eggs, a tub of yoghurt, 1/2 a large apple, 8 macadamia nuts, 8-10 grapes. If I go out to eat I can eat about 3/4 of a main meal in a fine dining restaurant when meals are pretty much recommended portion sizes. In Australia our servings aren’t as large as some of the American servings though they are getting larger in the casual eating places. For example, I ordered a small salt & pepper calamari meal at a pub & took half home for dinner. This is an Australian site (below) but I’m sure there’ll be US sites about recommended portion sizes to give you an idea. However, you need to work out what size portions will provide you with the appropriate nutrients and calories your body needs to function effectively and for you to maintain your weight. https://www.eatforhealth.gov.au/food-essentials/how-much-do-we-need-each-day/serve-sizes Your nutritionalist will help advise you on this too.

So, there's a normal meal and then there's what you get in a restaurant or what we've been taught to think is a normal meal. At about 8 months out, I can eat a full serving of chicken breast. That's defined as being between 3-4 oz. And in the same sitting, I can also eat a serving of broccoli, which is about 1 cup. I don't tend to eat grains often, but if someone gave me a serving of brown rice, which is 1/2 cup cooked, along with the chicken and the broccoli, I could probably eat about half of that on a good day, but not touch it on a day when I have a smaller appetite. Personally, I would be more likely to substitute a second veg or a fruit. What I've just listed would be considered a "standard" meal by a nutrition expert. It has about 280 calories and 24 g protein, and provides balanced nutrition from several food groups, along with fiber. But most people would probably think it was way too small, and if you went to a restaurant, you would get 4x that much food, plus half a gallon of fat and sugar laden sauce on top. And probably cheese, just for good measure. Could I eat that? No. And hopefully I will never be able to. A sandwich is tricky because of bread. I find bread too filling. I was out this weekend at a sports stadium and had to order my lunch from a food truck. I chose the grilled chicken pita wrap and ate all of the insides but treated the pita like a plate that got thrown away at the end. I do the same with a soup and half sandwich combo from a restaurant, eating the sandwich filling and the soup but ditching the bread.

@ShoppGirl how did all your medical stuff go? Are you doing okay? @Justarwaxx I have heard periods get worse when your losing weight because so much estrogen is stored in fat, so when you lose fat you have more estrogen in your body, which in turn makes you cramp more and your flow worse. That has been my experience so far. I was hoping I would have lighter periods since I'm not intaking as many calories.

Hey, i do have a question about Maintenance calories in general, I lost around 135kg's in weight in the first year, and im "slowly getting there" and even considered recreational surgery now, but i have problems with the idea of Maintenance Calories and goals. So thats why i ask here now. Is the General Maintenance kcal after the surgery lower than the ones for a normal "person" ? or do we kinda "slip into" that?. i know all the math about calculating it, but is the normal Calorie intake calc. for people with a rny Bypass even a thing?

Well today was crazy but I still managed to stay on track with my nutrition. I just finished eating dinner since I missed lunch and had to eat it late. I wasn’t really hungry so I just ate some chicken breast to get my protein. The good news is that my calories were way lower today so that should help offset the fact that I didn’t do any exercise.

mark me down as a cottage cheese lover. always have been. i like to eat it plain, with all kinds of fruit, and/or granola, nuts, seeds, honey. .... i also like it savoury: with black pepper, and/or cayenne, garlic/onion powder, more cheese, cured meats, bacon, anchovies, grilled veggies, balsamic vinegar....ha! (yes, you read that right: anchovies, lol!) i've also used it to substitute some/most of the cream cheese in cheesecakes quite successfully. lowers the calorie level and denseness of the result (but if you like new york style cheesecakes, doesn't really work...) anyway, i could go on and for my cottage cheese love (which i probably already did, ha!)... Cottage Cheese Forever!

I had to do the liver shrinking diet pre-op for 2 weeks. 2 shakes a day then I ate a bag of frozen stir fry vegetables with 3 ounces of lean chicken or beef season fried in soy sauce for my evening meal. It was delish. I lost weight. High volume, low calorie. I'd enjoy the food while you can. JS

sushi takeout for a super late lunch (actually this first meal of day...got distracted by errands and realized we were hungry at like 3pm...oopsies (1) the takeout box - so pretty, right? (2) my before and after (3) calorie count: 261 cals for all of it, ate almost all of it!...also had an espresso martini beforehand (146 cals) and almost ½ a chocolate dip donut afterwards (95 cals)...so approx 502 calories for what i just ate/drank.

Absolutely not. Not enough calories, carbs, nutrients. That's basically a starvation diet, and we don't support that here. You need food. For various reasons. The protein shakes are supplements, not complete meal replacements.

I struggled to eat enough to slow my losing though not as much as you are. I reached goal at 6 months and was barely eating 900 calories. It took another year to get to about 1300 calories and for my weight loss to stabilise. To increase my intake I was eating all day long or it certainly felt that way. I had three meals and 5 or 6 snacks, predominately in the afternoon and evening. It took another year +/- to get to around 1600 calories which is about what I eat now to continue to pretty much maintain that initial stabilised weight.. And yes I still snack but only 3 or 4 times a day now to meet my caloric needs. So, yes, some of us do take time to get those calories up. But you are a more extreme case. If this has happened in rare other cases, what did they say what treatment was used in those cases? Can they stretch your pouch via an endoscopy or balloon? Have they suggested you incorporate those nutrient dense, high calorie smoothies like Ensure used for those with digestive and eating issues?

It's not that we're trying to pick on you or force you to justify yourself. But honestly, what you're saying doesn't make sense. How is it your insurance covered your surgery and a panni but won't cover you for organ failure? How are you not in the hospital now? If your organs are shutting down, no way would they have just sent you home. I work in healthcare, and we've sent people to the hospital for way less than that. I would suggest eating carb and calorie dense slider foods. Mashed potatoes are great for that. Add sour cream and butter. There's a lot of stuff you can have that will add weight. I've been struggling to get my weight up, but adding protein shakes, avocado on nearly everything I can, slider foods, etc... And eat every 2-3 hours during the day and the evening before you go to bed. You shouldn't have to get up through the night to eat.

I'm really going to have to look into that, I think. I need to build muscle slowly without losing too much fat or burning too many calories.

My B-12 levels are right where they need to be. I have systemic lupus, which has always caused anemia. I actually have wrist and ankle weights, so I'll try wearing them and see how things go. I didn't even think about it, honestly. I'm just nervous about burning more fat and calories before I build any muscle. I haven't mentioned it yet, but besides my butt being flat and flabby now, I literally have almost no muscle there. When I sit on anything, I have to be careful because I'm literally sitting on bone. Actual bone, and it hurts. So I have to do this carefully.

Have you seen a bariatric specialist? It sounds like something other than a small pouch to me I am over 6 years out, but I still have a lot of restriction. My capacity for the last 5+ years has held steady at about 4 oz. So a small frozen burrito, a taco bell taco, etc. But that does not restrict the amount I can eat in a day, and certainly not necessary to stay up at night. Is there a reason you can't eat slider foods, calorie dense foods, eat more frequently?

BlondePatriotinCDA- I have been tracking my food and beverages until yesterday I was eating 500-600 calories a day for the last year waking up at night is the only way I am able to increase my intake. My symptoms aside from low calorie intake was severe hair loss, extreme fatigue like I could only be awake for a few hours at a time. I have epilepsy with medication I typically have 1 seizure a month, suddenly I was having severe a week. My mood also changed I am usually a very happy bubble person and my thoughts and emotions started going to a very dark place. I lost the ability to think clearly, could not even watch a 30 min show without losing g focus. I was snapping at everyone and I had a general unwell feeling and I started to get back pain and upper stomach pain. Then my blood pressure dropped low.

speaking of chicken, ha! this was lunch today, that i picked up after yoga classes (pro tip: don't buy take out on your way home from exercise class because it will likely be deep fried stuff like this omg). 1/3 KFC classic chicken sandwich, 1 KFC chicken tender, and 2 and a little bit of KFC onion rings (the cute little one was my favourite, lol) with a little bit of ketchup & bbq sauce: 462 calories for all of it. ate the tender and the onion rings, but got tired after one bite of the partial sandwich and gave up...so probably 275 calories for what i actually ate (mr. already ate the leftovers).

I'm sorry you're going through all this, especially since like most of us you went through surgery to become healthier. As far as the "under 900 calories" at 1 1/2 years out, I'm at at 800 at 15 months out myself. I've even asked about increasing my calories at my 12 month checkup having seen most ppl on these forums discuss that they've been put on 1200 calories a day at this point in the journey and I was told I could maybe add 100 calories but they were very hesitant about it. Now you have me worried. What symptoms are you experiencing? Currently, I have no energy, I feel like I'm dragging my legs and feet... I'm grumpy most of the time and I've started getting nerve or some kind of pain in my right armpit area... My joints ache was just thinking arthritis, I've been very hard on my body with 14 years of gymnastics and being in a physical confrontation job with ppl twice my size..headaches.. . could you if you don't mind share what you've been experiencing? Luckily my co-morbidities have all gone away so far.. Thank you for your post, hopefully I can address this with my GP next month! I hope you start to feel better soon I know this isn't what you signed up for. I take it your bariatric clinic kept you low calorie too?

Wondering if anyone else has had issues like mine. I realized reading other people’s posts that I was way behind on how much I could eat. I am still under 900 calories a day. I get horribly sick when I try to eat more. Over the last few months some of my pre existing conditions have suddenly gotten a lot worse and I have developed severe reactive hypoglycemia, with my blood sugars dropping as low as 32. After visiting several doctors and specialists a few who told me it was all in my head it was determined that I was slowly starving to death. They said my stomach pouch had not expanded like it should have and some of my organs were starting to shut down. They said it’s rare side effect but it does happen. They now have me eating every two hours even at night. Due to everything I was put out of work on STD. I feel so completely on my own with this and just wondered if anyone else has heard of anyone dealing with this.