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OK, some of you know I've adjusted my macros to follow my dr's plan instead of doing my own version which is much lower carb. Basically he has me eating way more carbs a day than I was comfortable with but the carbs are the 'low or lower glycemic impacting' ones. That being said, while it has helped the scale move down a bit...it is like I will go for let's say...8 to 10 days weighing about the same..maybe inching up or down by less than a lb. Then I will drop 2 or 3 lbs. I get leery of updating my 'progress' as I'm still distrustful that the next day or 2 the scale won't just 'jump up' again.. Since I have increased my carbs, I have noticed a direct increase in hunger pangs...growly stomach. Hitting my water finally so ruled that out...I never had relief (except for 2 days) from hunger so I've had to deal with it this whole time but I try to double check whether it is head hunger, old habits cropping up, etc. but honestly...I did not have this same hunger in the weeks where I kept my carbs under 20 grams a day. I felt more..let's say 'satiety' when I was eating more of a keto based diet. I've been a bit frustrated at dealing with the increase in hunger and the DECREASE in feeling well..not fullness...but feeling like I had eaten 'something' and had no desire to even eat another bit. So, I decided the other day that I was not going to wait 30 minutes to drink water. This was a particularly rough day..actually one of the days that I have felt the absolute hungriest since the initial week of pre-op liquid diet. After I have gotten my protein in, then veggies, followed by carb/fruits...and my pouch is not feeling 'yucky', I have started to drink after 10 or 15 minutes if my stomach is still growling. This usually takes care of the feeling of hunger. Anyone else resort to drinking (WATER!) as a way to 'cut their hunger' after eating?

I was on Trileptal as a mood stabilizer for a while and it worked wonders for me, and didn't add any weight. I will definitely say, that being on keto did almost as much for me as my mood meds though.

Ok, MickeyD, move over! There's a new sheriff in town! LOL. This might become my favorite breakfast meal! I give you the mcchaffle breakfast sammy: I over toasted it in the pan when I was reheating it. My bad. But it still tasted delish!!! I took this girl's version of the chaffle and changed it to my standard where I use ACV and baking powder in it and spices like onion and garlic powder. Cuz I think it adds to the flavor. Only 54cals and 3 net carbs per chaffle! Each recipe makes 4 mini chaffles or 2 large chaffles. This breakfast included 1oz of grape tomatoes. But you don't have to add them. Also, you can poach a single egg, I just added 15g of egg whites to make it thicker and add a little more protein to it. Here's Keto Rewind's version of the Chaffle Recipe. Really incredibly waffle-like! And here are my ingredients. I just mixed everything together with a fork and then divide it up into 4 mounds and cooked each mound for 2 minutes. I didn't grease my mini chaffle maker. I divided the 56g of mozzarella into 28g of mozzarella in two. Half goes into the batter per the link above, and have gets divided up between the 4 chaffle batters to sprinkle the extra cheese to make it crispy on the outside. Here are my ingredients:

Eat real food hon. Let your tool do its job. Ditch the crap=Keto Ice Cream and Barney's Almond Butter with Lily's chips, enlightened bar...WAY too much processed junk. This is the time to break up with treats and nut up/knuckle down. Make your meals as lean and protein forward as you can. Don't start using "crutches" at this point. It is WAY early and chances are you will stall out long before reaching goal. This is the time to MAXIMIZE your weight loss. It's the time you will lose the most. Don't squander it. Follow your doc's plan. At this point I was at 1/4c per meal and 400-600 cals. ALL of it was protein + a bite or two of steamed veg + a tiny tiny amount of healthy fat (ie 1/2oz of avocado = 1/8 of an avocado).

I switched over to mostly calorie-counting when I hit maintenance (I can maintain as long as I stay in the 1500-1700 calorie range - your range may be more or less than that - you have to experiment to find your "sweet spot"). I still mostly follow the post-op rules, though - I make sure I get enough protein, eat protein first, then veggies, etc. I do eat more carbs than I did while in weight loss mode, though - but the healthy kind. you'll just have to figure out what "works" for you (some people join Weight Watchers, some do modified keto, some people use intermittent fasting) while being sure you're meeting the protein requirements and remembering the order (protein first, then non-starchy veggies) also, I continue to log my food intake at 4+ years out. I think it's vital.

Not a stellar day on my part but i still in the soft food stages/ puree and my stomach doesn't agree with many things B- Collagen UltrA 19 CAL, MAX PRO SHAKE CAFE MOCHA 150 CAL, CLEAR PRTEIN DRINK (1/2) 32 CALS- 201 CAL L- 3 SHRIMP, T BSP GREEK YOGURT, 1/4 AVOCADO, 2 TBS SALSA AND KETO ICE CREAM - 243 CAL D- KETO ENGLIGHTEN BAR- 70 CAL SNACK- BARNEYS ALMOND BUTTER (NO SUGAR) AND LILYS CHOC CHIPS MELTED- 133 CAL DAILY TOTAL- 647 CAL, 31 NET CARBS, 64 PROTEIN, 34 FAT , AND BY EOD ILL HAVE 100 OZ OF WATER

The protein amount that is usually specified is nothing special (maybe a bit of overkill, but not much) - it represents the amount that we generally need to maintain our lean body, or muscle, mass, and will not change appreciably as we move from weight loss into long term maintenance. What will change over time is the amount of other things that will be consumed with it - fruits, vegetables, grains, legumes, etc. So things won't seem as protein intense over time. It will also become a basic habit (did you worry about your protein intake before you decided on WLS?) As with vitamins, it is something that we will need to make sure we take in some form - some will need more than others - and periodic lab tests will guide us on what and how much we need to take (including protein.) So, do you need to count and monitor it forever? Not really, as it will usually become habit and take care of itself. For instance, protein is only about 20% of my diet, so it isn't something that I think a lot about. Now, if you decide to make major changes to your diet or lifestyle (like going vegan or keto) then you should revisit the subject to make sure that you are getting enough of what you need.

This is a great site that might be helpful https://www.ruled.me/keto-calculator/

This site is very helpful for Keto and has a great calculator for Macros. https://www.ruled.me/keto-calculator/

Have you had any labs done yet (maybe a bit early, but some do them at 3 months,)? One thought is a bit of anemia, either from iron or B12 levels being too low. The other thought is diet - most of us are/were on a low carbohydrate diet by default (low calories, protein emphasis, not much room for other things...) and some take that to greater extremes by following one of the popular diets like Atkins, keto, paleo, etc. under the belief that they will improve weight loss results. When one is being particularly active, low carb diets can yield this kind of result, either overall lethargy, or running out of gas quickly. When on a low carb diet, our glycogen stores (short term energy reserves of carbohydrate) are being kept low, and it takes time to replace it with converting energy from fat - either stored or dietary - so we can wind up running short. It's like only filling your gas tank to half - it may not be a big deal if one is a stay at home sort making few errands, but if one is active and always out and about doing things, then one needs to keep filling up. I never worked to keep carb intake particularly low (or high - I simply ignored it) and never had any particular overall energy issues after the first few weeks. One thing I did run into at about four months was running out of gas after about an hour in the pool (just lap swimming). My RD suggested trying a pre-workout snack/meal that was relatively high in complex carbohydrate, moderate in protein and low to moderate in fat. I played with that and settled on a small sandwich of whole grain bread, meat and cheese, and that did the trick - breaking through that one hour wall. Hypothetically, that provided a bit of a blood sugar rise at about the time that I was otherwise starting to run low (or it was topping up my glycogen supply so that I had enough to go farther.) Note that this made no difference on the days that I did a weight circuit, as I never had any energy problems then, even though those workouts ran upwards of 90 minutes. So different activities can create different demands, so that is something to play with.

Literally no one: Me: *YOU ASKED FOR IT!* 😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂😂 ########### Keto Chicken Patties ############ Scratch made (basically made exactly like the Salmon croquettes) You could pulse it in a food processor to give it a more commercial texture but i did not. Also probably a candidate for airfryers... One day soon I'll get one 😉 *not pictured various spices 20191002_133833.mp4

Welcome to the site Many of us have experienced a weight gain. Its great that you have reached out and working on getting it back down. Pouch reset is going back to liquids and progressing back out to real food stage. (It does not shrink your pouch) It may help you feel your restriction a bit. Its one way to help get back to healthy behaviors. Another option is to start at real food stage if you feel reset is too restrictive. Some choose to change diet plans Keto, paleo, vegetarian,IF, whole 30 etc. Only my opinion. Whatever diet you choose, The key is logging your food in an app and staying with in your weight loss calories/macros. Basics: Food plan, exercise, hydrate You know what to do but it may be difficult to get your head back in the game. A few threads on the site that may help. https://www.bariatricpal.com/topic/425354-the-importance-of-doing-the-head-work/?tab=comments#comment-4776743 https://www.bariatricpal.com/topic/428113-🍁-oct-2019-challenge-🍁/?tab=comments#comment-4815439

My hubby has been doing Keto to slim up so we will both be in better shape..I love him but MAN does his breath stink! Sent from my SM-N960U using BariatricPal mobile app

I am going to do this. I had my sleeve done almost 9 years ago. My Dr. told me I would gain all my weight back in 5 years. I’ve worked very hard not to let that happen. I’ve gained 25 pounds back and I know it’s because I was eating carbs. I’ve been on the Keto diet for 4 months with my husband. He’s lost over 40 pounds. I lost 6 and gained them back when we went on vacation. I’m going to do exactly what you said. What kind of protein shakes and vitamins do you use?

Some of you know I was interested in the IF topic but since I'm only 8 weeks out, it is probably not time for me to try to introduce that. As I am a super slow loser and am very metabolically challenged..I tend to opt for a keto based way of eating. Keeping carbs under 20 grams, etc. Keeping fat isolated to much less than the average 'keto WOL' and staying with the healthier fats. I've been stalled at the same weight for 10 days and I have been exercising during this time. Haven't noticed any new change in the way things fit (looking for non-scale victories, etc.)..and before that it took 2 to 3 weeks to lose 2 lbs. Was aiming for 800 calories or less with protein as highest macro followed by fat and then by carbs. When discussing IF on another thread, I posted what my dr recommended and it is based on 800 calories a day with 40% protein, 30% carbs, and 30% fat. I'm so nervous about changing my diet around, increasing carbs, etc. but at this point, I'm so frustrated with my slow losing pace and my stall, that I figure that I might as well try it. I've lost 32 lbs in 8.5 weeks which probably sounds ok to other slow losers but what bothers me is that in basically the last 3 wks of my 8.5 wk journey, I've lost roughly...2 lbs with the past 10 days at a big fat 0. I was ok with just losing 2 lbs a week..but i feel like my weight loss not only started slowing even more in the past several weeks, but it is now trickling to a standstill and I'm only 8 weeks out. I figured I'd see something like this starting maybe in month 4...definitely not month 2. I've tried to stay positive but that it is becoming harder and harder to do so...

I was a fan of fruity drinks and Long Island Ice Teas. However, as I did keto WOL for so long before surgery, I went to having an occasional diet coke and rum (technically keto friendly), HOWEVER, this was more of a once or twice a month thing before surgery. For me, since I"m only 8 weeks out and I'm in my THIRD stall AND I am a very very very slow loser even sticking to my dr's plan 100%, while I have had brief temptations, I know I'm 1) Not Ready to try this 2) Unsure if I should ever try it 3) Not willing to add something else into the confusing equation of why I am stalled yet again All this being said, I will not lie and say that I feel 100% confident that I will never have another drink. We are going on a Christmas cruise with my 89 year old MIL as she wanted the whole family to be together at Christmas and wanted it to be on a cruise...so we are all going. I have wondered about the possibility of having a drink at this time.. Unfortunately I will be only 5 months out at this time. I wish it was more like 1 year. I'm also unsure if I want to try my 1st drink, if I even do, on a ship with my whole family around...have no idea if it goes awry, how fast I could get to a place of privacy....you know? I have wondered what in the heck I would 'mix' any alcohol with and my eldest pointed out that my Premier Clear Protein Tropical Punch drinks would probably work...I was like "yeah, thanks for pointing that out...and now it is in my head". Only thing I know for sure is that for today, I choose not to drink alcohol.

I completely blanked on this....I literally am having a hard time remembering things lately..to the point it is a bit embarrassing. Ironically, when they told me to start on real foods, P3's were mentioned and while I had a huge adverse reaction to scrambled eggs in the soft food phase, one of the easiest things for me to eat and keep down out of the P3 packs were actually the nuts! It is SO weird how different everyone's experience with certain foods can be. I literally sometimes gag when I'm eating lunch meat type items..and even cheese..I start to get nauseated after eating about 3 or 4 cubes..but the nuts..no nausea, no vomiting, no pain. Often I leave a few chunks of both meat and cheese uneaten in my P3 packs. I did keep to soft food phase today though. Nothing sounds good but my stomach is letting me know..my pouch...that it would like something more than 1/2 a protein shake. I'm out of cottage cheese but am grabbing a carbmaster yogurt. Thanks for your continued input. Truly didn't mean to disregard your wise advice. I think my brain is clogged sometimes I'll give my dr's plan a try - the carbs are definitely all what I call 'low glycemic impact ones' and I have at times during my intense 15 months of keto (I say intense as I was continually keeping carbs under 20 grams), sometimes when I'd stall, eaten/added some healthy carbs for a day...and then the scale would move again.

Keto and Co is a full and growing line of ultra low carbohydrate, keto-friendly foods with 1.5 grams net carbohydrates per 100 calories or less. They're now available at the BariatricPal Store.

Thanks for responding, Fluffy, especially with such a well-thought out post. I understand now that I may be 'too early' in the process. I'm such a slow loser and am hitting multiple stalls...that I was looking for anything I could do that would help. I have started tracking my food/water/liquids intake in the myfitness tool now that I was given macros by my dr's office but their plan has me consuming more carbs than I am comfortable with as I'm a big keto devotee and I lose better when I keep carbs low as a general rule. I did 'Atkin's' way back in the day and lost 80 lbs and kept it off for a decade. I restarted a keto WOL 15 months before having surgery as this way of eating helps my body feel better. Now I'm wondering should I follow dr's plan & not attempt to modify to be lower carb...unsure if only being 2 mos post op if my body would prefer that...but having had this body for a number of yrs (lol), I have such a difficult time losing weight...period. Usually it comes off much faster when I keep carbs below 20 ideally...or 30 for a stretch. Below is your list and I just wanted to put my responses in but I get what you are saying about it being too early for me to do IF. I'm hoping some of the things on your list that I'm already doing will have me better prepared should I go down the IF route later in this process: 1. FOLLOW your doc's and RD's plan for you and the stage you're eating at. You MUST be able to easily get the required protein in per day that they prescribe for you. And the amount of fluids you're told to consume. 2. Follow the rules of WLS. No eating drinking 15/30 or 30/30 depending your doc's plan. 3. Get ALL of your daily Vitamins in without skipping a single dose. I've been fortunate that I haven't had an issue with this even directly after surgery 4. Get to walking. And maybe even get to doing core strengthening exercises. Started hiking with youngest daughter several weeks ago. We've been consistent to this day. We currently do 2 x's a week and are looking to increase this but waiting for temperatures to cool down so we can do so..I also swim in my pool a couple times a week. 5. Protein first at every meal/snack >> al dente veggies >> a tiny bit of healthy fats (and that's it). Protein always first, especially since I'm only 2 mos post-op. If protein goes down ok, then I eat whatever veggie if i have one. 6. Cut out ALL C.R.A.P. (google it)--that means no sugar, grains, starchy root veg, starches, refined products, fake stuff, "treats" such as Protein Bars or Water drops. Severely limit the use of sugar substitutes. Did this 17 mos ago when I embraced keto WOL although I never believed in enormous intake of fat so my version had fats limited to ones that are healthier. I tended during this time to stay away from protein bars but if in a desperate pinch as I had a bad habit of not eating regularly (working so much I'd forget to eat, etc.) I might have one. I was a big user of artificial sweeteners during this period although I kept an eye on the research about them possibly causing hunger and many other things about them. Currently my limitation is 2 to 3 packets of splenda (or another fake sugar) a day in my post-op world. 7. Start drinking green tea now (I use decaff) and look into Earl Grey Tea. Ironically I just got a tea brew bottle and a pack of..I think it is green tea in a subscription box that I get. 8. Try to keep your carbs to <30g net per day (subtract Fiber grams of carbs from the total carb count to get net carbs. Yes, I'm a big believer in this! Trying to figure out how to fight myfitness pal as it does not have food listed in its DB, from what little I've seen, with net carb count. I may have to hand add all my stuff 9. No "snacking". Eat 3 meals + 1-3 small mini meals per day in order to limit meal portions to the volume recommended by your doctor and to reach your protein totals each day. A mini meal is an organized, orderly, planned event. Snacking is not. Snacking is hedonistic and reckless and it's possible to do a lot of damage with a single snack event. Since I'm 2 months post-op..this is usually covered although I am not yet this structured as I'm still having occasional issues at mealtime. My mini-meals are not yet planned, thought out events. Well, it's more like I know I will have a carbmaster yogurt in between my breakfast premier protein shake and my next 'meal' which is always an intake of real protein (i.e. meat that I can tolerate and is not a fatty meat). I also will parse out 7 almonds, etc. I think where I'm at is more like 'practicing for where I need to be'? I DID find myself recently..and it is always late at night as often don't eat my 1st meal of the day until almost 11 AM...going to get sugar free jello, sugar free popsicles but I was NOT hungry. It is old habits trying to creep back in. Was really upset that I started to 'go there'..this is a very slippery slope for me! 10. Aim to get 2-3oz of protein per meal (lean dense protein, no casseroles, no deeply satisfying gooey cheesy high reward meals. Keep is simple: grilled chicken, sauteed chicken, poached or sauteed fish, etc. No meat lube or stuff that adds to the pleasure of the food experience. My protein meals are much like what you said. Haven't had a casserole yet...wait, I did. It was shredded chicken I made in crockpot with chicken broth,fat free cream cheese and salsa..but no cheese involved. It is one of the few ways I can get 'moist' chicken. The macros do fit into my keto version including keeping the fat down more than most keto plans.

@FluffyChix & @Orchids&Dragons I was going to try to dive into the IF fasting thread and made it as far as detailing out your (Fluffy's) Down Days, up days and I think um..medium days. While I don't mind doing research, I was wondering if along the journey with IF which spans many many pages, did you change over to something other than what you started your IF journey with? I see ppl post 16:8 - is that 16 hrs of not eating followed by 8? I did try to follow some of that & am HIGHLY HIGHLY interested in research and cold hard facts about extending telomeres (sp?)..I think they are called (re: aging). So specifically looking for something targeted to getting physical age when measured by a physician to improve over my true bio age...does that make sense. ABOVE ALL OF THIS THOUGH, I know I have a very metabolically resistant body. Part is going into early menopause in 40's...a crap diet for over 15 years...inflammation issues with messed up knee. IBS issues since a kid (keto helped me out with this a lot). Starting to have ovarian pain so am worried about cysts...you know the deal. Was diagnosed with malignant melanoma last year, early stage, but I know melanoma is a tricky...very very tricky and insidious cancer sneak. I feel like my body is screaming out for help and I want to do what I can, even at this age...to finally...care for it. See if I can reign in or stop progression of some things Of course, one of the top pty's is continuing to lose as much weight as possible during this our honeymoon period as I call it Serious @FluffyChix I would even consider paying you for a session just to help me get a quicker grasp on things. Weight Watchers started that recently with 'coaches' you could hire and schedule time with. Think about it perhaps?

I was low carb coming into the WLS program. I believe it really helped me lose and also helped control my PCOS. It also kept me full longer. Post op, my RD/nor doctor gave me instructions about carb consumption--only about protein reqs. They also gave me samples of the diets for each phase. I made the decision to continue with my low carb plan. Very low fat keto--more like the Dukan diet. It's helped me get to goal with very little hunger respectively.

I'm a certified keto coach and after bari surgery, the rules are a bit different. You need protein to be your focus so may be eating more often than we recommend for the average Joe and you do NOT want your diet to be 75% fat, you want minimal fat, at a later date you may be able to increase the fat a bit as your carbs are below 20g/day to be properly keto so you need energy from somewhere. In the early days post op you just want to focus on your protein and fluids, which will put you into ketosis anyway. Loads of different ways to do keto, there is dirty keto, lazy keto, strict keto, so while you are recovering and on low carbs anyway research lots and find a way to do it that will fit in with your lifestyle.

So the original "keto" as developed in the 60s and 70s by Dr. Atkins was much lower than todays' present iteration of the diet. For a normie Keto Diet based on Atkins 72, most fat % were in the 60-75% range. When I followed it as a normie, I had to be between 55-65% fat in order to lose the best. Most of the LCHF/keto docs agree that the amount of fat in your diet entirely depends on the amount of adiposity on your body. That means, that even with a keto diet, you still must operate in a caloric deficit so that you burn the fat stores in your body rather than the fat in your diet for energy. And for the most part, you must expend the energy from your diet before you tap into your fat stores. As @AZhiker and @KarenLR75 say, there is no need to inflate our fat to "today's keto" range. For most of us PO, it would be difficult due to surgical malabsorption. Even VSGers can have difficulty with higher fat. By simply reducing carbs to 20g net or below per day and putting your personal prescription for protein into the equation (given to you by your surgeon), then you can back into your target calorie goal and figure out your fat grams/percentage based on that. Any additional fatty acids you need (and the ketones produced through lipolysis) will then be able to come from the fat strapped to your booty and middle (and total body) rather than the fat bomb or MCT oil, or butter coffee -- or whatever ridiculous bolus of exogenous and unnecessary "keto bs" you consume. I knew that in order to lose I needed to maintain a range between 650-850 calories/day. I know, because when I got to 850 calories or above, I would stall out and not lose anything. I also knew from my surgeon and RD that I had a broad protein range (in the early days) of between 60-80g protein daily--with an optimal amount at 74g for my LBM and are based upon height, sex, age, physical status. Males and females of a different size will have different macros. Here are the macros I've used to lose 157lbs:

Ditto what AZHiker said. I'm back on keto with exception of fat %. I use vinaigrettes for salads and some salad dressings that straddle line between low carb and low fat. I use spray butter instead of butter, avocado mayo mixed with low fat mayo or greek yogurt and I use sparingly. Instead of full fat heavy cream, I opt for a splash fat free 1/2 and 1/2 )or vanilla protein drink). On rare occasions if overall carbs are low, I will use 1 TBSP of heavy cream in something but that is rare. I use fat free cream cheese, etc. - I think you get the picture. On top of this, since my calories are between 700-800 a day I still can be in ketosis sometimes partly from lower calories & part from low carbs. I notice when I stick to this, I lose weight faster. If I do some of the 'low glycemic carbs' like oatmeal, sweet baked potato, beans, I notice slow down in loss but I've had these items sparingly.. My surgeon is a keto fan after full healing when he lets his us start eating "regular food" . On the ongoing nutrition plan I just received, they had the macros as follows: 800 calories with 40% of total calories from protein, 30% from fat, and 30% from carbohydrates this should help increase your rate of weight loss. I can understand 800 cals & biggest % being protein but I was a bit surprised by 30% from fat part although I know they mean healthy kinds of fat like avocado, etc. Here is what plan says about fat: Limit fats to 2-3 servings a day; avoid unhealthy fats such as cream, lard, butter. 1 serving of fat should = 5g fat. Some examples include: 1 tsp. oil, 1 Tbsp. regular salad dressing, 2 Tbsp. reduced-fat salad dressings, 1/8 avocado, 6 almonds, 1 Tbsp. peanut butter. In looking at sample meal plans, I will revise it for me by removing some of the bigger carbs that the list has like once a day having oatmeal or 1 pc whole wheat toast as I need to keep overall carbs down to lose more quickly.

I could never handle the high fat part of keto. Since surgery, I definitely have fat malabsorption and if I eat too much fat, I pay for it in the bathroom. I also had fatty liver disease prior to surgery, and from what I've read, hitting the liver with even more fat is probably not a good idea. Poor liver is working hard enough to break down all the fat from the weight loss process. Maintaining a low carb approach is still a good plan, but for me the priorities are protein and then veggies, but without the high fat of keto.