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@mxpxchik11 I would listen to the Dr. I am not sure what kind of practice you are going to, but the one I went to has a shared dietitian. The information in the book and what the dietitian said are not the same as what my Dr said. He actually gave me a separate sheet that he just gives to his patients on how he wants you to eat. Every Dr and Surgeon I know on a personal level (friends, family friends) all eat Paleo/Keto/Low Carb. If your Dr is telling you below 25 grams, follow their advice. It is honestly very easy to do anyway, if you are just eating protein and veggies. Your dietitian is right about eating more meals and getting your calories to 1000, you want to get your calories to 1000-1200 ASAP so you aren't stuck eating under 1000 calories forever. At that stage I ate 5 times a day, and I still eat 4- 5 times a day now at almost 2 years so I can meet my protein goals.

There are a few bariatric keto plans out there..... What I've been told is for keto do High protein 60 -80g or whatever your doc recommends. Moderate healthy fats and low carb and lower calories. Just search for bariatric keto truth and groups like that on facebook Sent from my SM-G965U using BariatricPal mobile app

When you eat keto (basically high protein, good fats, no carb) your body enters ketosis. Eating carbs will stop ketosis. Your body will retain water again until you re-enter ketosis. That can take a week. One cheat can stall you a week or cause water gain. If you plan a cheat, ditch the scale. For at least 2 weeks.

Today is 1 month and 1 day since I had my VGS surgery. And I can’t tell you all how happy I am to have had this surgery. It has made all the difference in the world to my life. I have 10x the amount of energy I used to have, almost like I have a bounce in my step again. My SW: 260 My CW: 217 GW: 175-180 It just seems like it’s really working. What I wanted to share with some people that seem to be struggling with the weight loss is that I have made my diet mostly keto. I understand carbs are just as important during the recovery time, but being more keto has helped the weight come off faster. Faster than even when I was not eating much after the surgery. I am really surprised by how fast it is dropping now... I think I’ll be at my goal weight before I even know it. Because of all this new found energy, I have been able to do so much more. I want everyone to be this happy 😃

I do low carb, not "keto". I make that distinction cuz I am old-school. I don't do a bunch of fancy gyrations and artificial stimulation to get my fat high. My keto comes by simply doing no more and no less than dropping my carb level to <50g per day. That gets the body into ketosis. But to be fair, most of us who are eating <800cals per day are probably already in ketosis by proxy of a VLCD (very low calorie diet). So we're already producing ketones for fuel--unless you're consuming a butt load of daily carbs in that 800 or less per day diet. It's can be a good and healthy diet. I do low fat; choose low fat proteins and reduced fat dairy, but my fat still falls in about the 40% range. Anyway, it works for me. But if you over-consume carby food, you WILL see a jump from glycogen stores refilling with water and it takes 2-5 days to re-empty them. That's anywhere from a 2-8lb weight gain overnight. It can be brutal psychologically. But I truly believe this is the way that will maximize my weight loss period. For me.

You can buy keto strips from amazon to test they you are in ketosis. Usually anything over 20 carbs A DAY will keep you from being in ketosis but with the strips you know for sure if you have wiggle room to up carbs or go lower. Unless you are exercising vigorously it’s usually 20 and under though. Hope this helps. Yo-Yo Girl from New York City

From what I've read here and having had 'different surgeries' before, mood swings (hormonal or otherwise) are actually experienced by most although different ppl may process (or not) in other ways. It is very very normal I totally get what you said about everyone going and doing. I posted on another thread lately I feel..super ALONE. My family eats out "because they are uncomfortable" eating around me or as they also say "they don't want ME to be uncomfortable". I'm PEEVED because all they are doing is making it WORSE. I've said that I need to be able to be around food although I'm not inviting them to make all my fave foods and have a buffet either. What they are doing is making me feel more left out than I did before. I feel LONELY. My husband & I would go to dinner once or twice a wk and now that is done so he and my youngest daughter are now going "out". Am NOT begrudging family going out to eat & continuing with their life as I have to keep reminding myself that this..almost quarantine like part of the journey is about keeping ME safe and honestly, I am a week post op myself. I think there is some truth in their comments but there is a load of truth that they are eating foods I already was staying away from (did keto for 15 mos) and eating/drinking too much (not being rude, I was queen of overeating..I think THAT makes them uncomfortable AROUND me maybe? It is hotter than Hades here in TX and I did not do well in extreme heat before surgery and I've got to remember - I just had major surgery. Just made a major change to my body & it has to HEAL. I remind myself that before I know it I'll be able to go 'out again' but there are also temptations there that for now..I choose for myself to avoid. I have stated what I am and am not comfortable with. If someone is making or bringing something around that is tempting. I will move to another room and read a book, play some games...I just started buying jigsaw puzzles cuz it reminds me of my mother. I have found them to be very therapeutic. I come here & read the 'headwork thread', the JULY and now AUGUST challenges greentealael (is that right) posts have been enjoyable even on the days I didn't participate. There is a humor thread that is hysterical. Give yourself a break and a big dose of self love. We are JULY surgery siblings! I've given myself permission to have a good cry and I know there is a big emotion shift of finding new ways to fill up my time besides eating. Sounds like a good time to get to know ourselves better. You know you are amazing and worth it! Remember what a brave thing we just did..as 99% of everyone on here did. We did it because we MATTER!

it really depends on what ur goals are... rapid weight loss? sustained weight loss? maintenance? muscle building? fat loss? carb reduction? fats loading? anyway...i used the following calculator to determine my optimal macros based on a modified keto diet (kinda like Atkins II, sorta). it worked for me until it didn't...the macros i was aiming to maintain was really not sustainable (for me) in the long run. im 5+years post op now and don't look at macros anymore (haven't done so since year 2)...now i just keep an eye on total calories (no matter how they are comprised). i've been able to maintain below goal weight this entire time just on maintaining a caloric limit alone....but thats just me...ymmv. but anyway, here is the calculator: https://www.ruled.me/keto-calculator/ good luck! ❤️

Patience grasshoppah! I agree with Tea. Go back to do one thing at a time. Go back to your old way of eating LC or Keto or whatever you choose to call it. You are likely hungry with it cuz you're keeping fats pretty low. Maybe up your fats and see if it helps with satiety? But when I say "up" them, I'm not talking fat bombs or desserts, or lots of added dietary fat. I'm talking about: 1. Switch from boneless skinless breasts to breasts with the skin. Or switch to thighs. Or eat beef pot roast. Or eat pork shoulder. These cuts naturally have more fat in the meat and so have more calories and are more satiating. Also if you are only eating 2oz per meal (by weight) of protein, try eating 3oz. if you are eating 3oz per meal, try eating 4oz. until you hit your daily protein goal. If you hit your goal easily and go over on protein...then you may need to look at re-apportioning your protein/veggie serving size to fit your macros. I'd add a small salad with vinaigrette to each meal if that happened. I rarely eat more than 3oz per meal cuz I don't need the extra protein. 2. Eat 1-2oz by weight of al dente veggies. Add 1tsp of fat to them (avo oil, evoo, coconut oil, butter, ghee, animal fat) or add up to 1oz avocado, or 1/2oz by weight of nuts/seeds. 3. Eat 3 meals per day. Try not to snack. If you are hungry allow a snack composed of these (choose one): a. String Cheese b. Hard Boiled Egg c. 1oz dense dry protein. This will put you in ketosis big time by the end of about 4 days. You will lose 2-4lbs of water from it as your liver dumps glycogen and the attached molecules of water it holds. Then do that for a month and don't worry about it. That's your new diet. As your pouch matures, you will need to revise it to add more fat/calories to your day, or continue to choose more fat dense meats/dishes. If you are struggling with weight loss, I would stick to this and I would avoid calorie dense complex meals such as casseroles, stews, gooey, cheesy stuff. I'd stick to clean meats, healthy fats, al dente veggies. Hope that helps! Congrats on your losses!!!!! Don't stress, don't worry! For me eating in maintenance is longer than 2months with no loss on the scale or by the tape measure. For me a stall is 3 weeks without a change on the scale or by the tape measure. Other people have different definitions.

I'm 7 months out and have been doing well I've lost 100lbs. The other dau I went to blaze pizza and got a keto crust pizza with no sugar sauce and smoked ham with a few veggies. Ate 1 slice (I've done this several times before) the next day yesterday at lunch i ate 1 slice then some watermelon of which I've had before. 2 hours later AT WORK my hands started to shake and my heart rate went to over 100 I felt so weak almost faint I was able to get home and I fell into the bed TERRIFIED. I never had pain, nausea, or loose stool. I laid there in a stupor for about 2or3 hours and it went away. Okay family. WTF was that? Was it the watermelon juice pushing the food thru to fast? What? Please put your thinking caps on because now I have ALL food anxiety!

I get 60+ grams of protein a day, but try to get at least half from plant based healthy carbs (beans, nuts, whole grain breads, peas, lentils, seeds, protein pasta, potatoes, oatmeal) Am definately NOT a keto person and I don't count carbs. I DO, however avoid high glycemic carbs that cause rebound hunger. I eat every little sugar or processed carbs. (if I eat them...they're part of my 75 calories of "sweets"...and I don't always eat them. Nice to know they're there, though!) I keep my meats incredibly low fat. Use olive oil or avocado for almost all fat. I eat mostly fish, chicken breast and extremely lean steak if I eat meat. I LOVE a veggie burger, mycoprotein meat substitutes, etc. I'm a fruit bat. Love fruit and eat a LOT of fruit. Am particularly fond of dried figs for sweeteners in stuff lately. Natural sugar+high quality fiber is a win for me. I eat watermelon and strawberries a lot. I do fermented foods and foods with fiber like split peas...cause my microbiologist kid keeps telling me I need to build good gut microbiota. I love culinary zing. Ginger, garlic, five spice, red and green curry paste, garlic, balsamic, seseame seed oil, fresh herbs, miso, flavor! I do drink coffee, I use Splenda a lot, and sometimes I bank my 75 naughty calories for a few days and splurge on something really naughty like my mom's poppy seed bread, or something decadent when I'm out to eat with hubby. I eat my junk food out of the house, with a witness...which I know is weird, but helps me stay accountable. An almost daily staple in my diet is homemade veggie soup:

Sounds like ketosis, the metallic taste is a dead ringer. Ketosis is the state of your metabolism switching from Ironing glucose as a primary fuel source to burning fat. It can be burning stored fat, or dietary fat and most likely a mix of both. Your body contains approximately 300g of glucose "on hand" stored in your muscle tissue. Once you cut your carbs, those stores get depleted and your body turns to an alternate fuel source, fat. Your liver generates 280g of glucose every day for brain function and cellular functions every day regardless of your diet, so there is no danger to remaining in ketosis. When fat cells are burned, there are by products called "ketone bodies" or ketones created. There are 3 types of ketones, and you can buy urine strips that will test for 1 of them. When you first start ketosis, your body sucks at using ketones and so that "spill" over into urine. The longer you remain ketogenic, the more efficient you become at burning them. Beta-hydroxybuterate is one of the ketone bodies that has been shown to have very beneficial results on the heart, and is a preferred source of fuel for the brain. While initially in carb withdrawal and your body can't uptake ketones properly, there is a syndrome known as "keto flu". But after the initial withdrawal subside and your body adapts to using ketones as well as fats for energy and fuel, there is evidence of increased mental clarity and acuity as well as dramatic improvement in heart conditions. Sorry if this is more info than you wanted, just chewing the fat, so to speak.

Been looking for a sleever who follows a ketogenic diet coz from what I read so far I got overwhelmed by its complexity - even though my carb addiction tells me keto is my only way out of this mess. How r u doing so far? How are the macros especially on the Protein side? Would u recommend it for ppl who had done vsg? Any tips on how to get into that lifestyle? Been failing every day for a week now and giving in to my carb cravings every night :/

Why on earth would you do the Keto diet after surgery? It’s terribly restrictive and you’ll struggle with dehydration and risk dumping because of the high fat.

Hello, so I know that this is bad but I'm wondering if post-op after a few months if I wanted to try the keto diet, can we have meats such as sausage, pastrami, steak? Obvioulsy that won't be my entire diet it'll be mixed in with lots of non starchy vegetables but wanted to know if those meats were allowed.

You can definitely do keto, but it might not be especially high fat for a while--most bariatric nutritionists seem to favor a low-fat, low-carb diet for new patients. And very few people get through the first few weeks without something artificial. (I relied on sugar-free jello, sugar-free popsicles, and SO MANY PROTEIN SHAKES.) If you're really dedicated, though, you could probably minimize most of that. For instance, Eggface suggests "double milk" (1 cup Milk mixed with 1/3 cup Nonfat Dry Milk Powder = 16 grams of protein per 8 oz. serving) as one option. Most plans won't force you to eat beans or fruit or high-carb veggies, though; the focus is very much on protein sources, mostly animal-based ones. If you're worried about dumping from high-fat keto, you might consider discussing the option of the sleeve instead of the bypass with your surgical team. (There are people with sleeves who experience dumping, but it's pretty rare.) But like Matt said, not everyone who goes bypass has a dumping problem from fat, either.

I would not add sugar. It can stimulate cravings for carbs. Have you thought about following a strict keto diet to get the remaining pounds off? I did keto pre op and now post op. Once you are off carbs, the weight melts away and you won't have cravings for sugar. My husband has lost 40 pounds since I started my pre op diet.

Anyone else feel guilty eating mashed potatoes in the purée stage? Prior to surgery I was strict keto for 2 years and potatoes were like a deadly sin LOL Next weeks grocery run I think I'll be grabbing some mashed cauliflower...until then, the real thing won’t hurt since the quantity is so small, right? (like 2 tbsp)

Fortunately, all went well. I lost 29lb in the three and a half months since my first appointment doing a sloppy job of keto and not exercising at all due to my bad back, bad feet and bad shoulders. They'll be submitting my paperwork to Cigna for approval tomorrow, and the staff said it usually takes up to two weeks for Cigna to process everything. Once the approval comes in they'll schedule me for surgery and I'll make an appointment with my PCP for my pre-op physical. My best guess is that I'm looking at mid-June at this point. The good news I got is that I will not be having my procedure done outpatient as I'd previously been told. It turns out that Cigna requires an overnight stay, so I'll be having the surgery at the hospital and will get to spend the night. While I'm sure the doctor would not do it out patient if it wasn't safe, I prefer the idea that I'll be monitored for at least the first 24 hours following surgery. So now I wait. Many people post about their nerves and fears yet I have none. My wife had a knee replacement two weeks ago and I was perfectly calm. I've had two epidurals in the last two months and didn't worry at all. I even took my daughter out driving on Sunday morning, her first time behind the wheel, and even then I was utterly relaxed. I'm really beginning to think that at this point in my life nothing is going to phase me any more.

I think having any expectation around weight loss is difficult. It’s really going to depend on: - how long ago your surgery was (it’s faster right after, it definitely slows down after 6 months - age/height/gender (never ever compare yourself to a 20 something male!!) - current weight (if your BMI is very high, you can reasonably expect a higher loss) - activity levels and exercise - your diet (how closely are you following it? What are your calories/macros? Some plans target faster weight loss, eg keto, some aim for you to lose slow and steady. - other factors, eg your hormones, gut microbiome). Even then, there will be fluctuations. Some months you will lose more and some less. This is a long road for some of us. And you will stall, and then suddenly you will drop a few rounds really quickly. And it will be annoying. My advice is to be patient and honest with yourself. If it is weight loss is slow, assess how you can improve without beating yourself up!

Keto is (was) not a fad diet. It's effective for children and some adults with seizures and other health issues. People assume it is a fad, all the new low carb diets are based on it. My nutritionist said if you wanted to do keto at stage 4 it's fine, but I'm not keen on giving up dairy and I'm growing green beans lol!

Sometimes I think when people deny themselves constantly...they set themselves up for bad choices. I think you've been making some bad choices with the refined simple carbs. But I don't think the answer is to swing the pendulum all the way in the other direction and starve and create an unsustainable diet again. Something drove you to crappy choices. You need to find out what. If it's an emotional issue...therapy is a good thing. If it's a diet that's too restrictive and unlivable...don't go back there....do something new. Maybe try a moderate diet with some healthy unrefined carbs (beans/whole grains/fruit) and see if they will help control your carb cravings so you don't go overboard in an unhealthy direction with refined carbs. If I eat a carb restricted diet...I crave sugar like a lunatic. Makes me crazy. But if I eat healthy low glycemic index carbs.....I don't miss it much. I feel much better physically and want to exercise more. Different people approach this stuff different ways. Keto is the big trend and people swear by it because its' great for weight loss. But some people feel ghastly on it and it's unsustainable for them. Lot of ways up the mountain. If one path keeps getting blocked, maybe look at some of the other routes? Best wishes, and heartfelt hopes for better days ahead:)

I disagree with with Dabeyhive and RickM's comments above. Sure, keto isn't for everyone, but it's great for many people. I love the fact that it gives me some firm rules to follow and it happens to fit my eating preferences. First, I don't believe Keto is a fad diet at all. It's been around in various forms since the 1920's and became the basis of the original Atkin's diet in the early 1970's. It works very well both for weight loss and general health benefits. The problem is that some people don't really understand the diet or follow it correctly--and that's where people into problems. Following a proper Keto diet doesn't mean you should be chowing down on cheeseburgers without the bun eating bacon with every meal. While cheeseburgers and bacon are not prohibited on Keto, those aren't recommended either. You should stick to things like organic eggs, lean organic meats and wild caught fatty fish (like sockeye salmon). Stay away from fatty meats, since the fat is bad things the animals consumed are stored. You then add healthy fats to your food, like avocado, MCT oil, extra virgin olive oil, ghee etc. The idea is to "prime the pump", so you body burns off its excess glycogen stores and then converts stored fats into ketones for energy. This is important, especially if you're insulin resistant. For me, I am really happy with Keto and I can definitely stay on keto long term. My surgeon and nutritionist are on board with my keto choices. I just had my blood work done after 2 months on Keto and everything was perfect. I am no longer diabetic (A1C dropped from 6.3 on multiple meds to 5.1 on no meds). My triglycerides dropped to 54 (they were 450 this past summer on meds). My cholesterol is 190, but my good cholestrol is 97 (which is outstanding)--so that's good. Some of these may be from the surgery, but diet and exercise are equally critical. I suggest that you don't do keto on your own, but you do with with the guidance of a doctor or nutritionist that has a lot of knowledge about keto. I personally keep my net carbs down to approximately 20g a day and close to a 1:1 ration of fat to protein. At this point, I am 14 weeks post op (99 days). I am eating between 1200-1600 calories a day. Those calories are made up of 45% protein, 45% fat and 10% carbs. The carbs I am consuming are mostly from vegetables--even green veggies have some carbs. I don't eat any bread, starches, potatoes, sugar etc. I avoid high carb fruit, but I am allowed berries. I avoid processed foods to the greatest extent I can. I also work out daily--at a high intensity (and have been since I had all physical restrictions removed 1 month after surgery). I have lost 70 pounds since my highest weigh in. My pants size has dropped from a 44 to a 32. My body fat has dropped from 28% to 16.5%. Weight loss surgery is only a tool (a good one), but I would say it gives you a head start and helps prepare balance your body's hormones and stomach so people like me (morbidly obese, with a trifecta of co-morbidities) can lose weight like a normal person without insulin resistance/diabetes and other issues that get in the way. Once I had those issues, in check the rest of it was up to me--with keto and serious exercise making the big difference in getting me to where I want to be. I'll let my pictures speak for themselves: The was me on July 4, 2018 (weighing around 255-260) : This is me on the day of Surgery (weight 235): This is me on March 23, 2019 (weighing 190): As a 45 year old man with diabetes etc., no way I could have done this without VSG. However, I really believe Keto and exercise (45 minutes moderate to high intensity cardio 5-6 times a week and 1 hour of high intensity weight training 4-5 times a week) have changed my health and my life. I can't imagine going back to the life I had before surgery, nor could I imagine not living a keto lifestyle at this point.

Thanks for the advice I'm trying to get as much Protein in my diet as possible. I have bought a Keto diet/recipe book so hoping that will give me more tips thanks again! Sent from my iPhone using the BariatricPal App

After 6 months, Keto Krate if you eat Keto, but honestly. I think it is a waste. Like my tastes are so varied yet specific, there is no way I can roll the dice on people sending me random stuff. What I want to eat changes from day to day. It would take me months to get through one box.