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If you had a DS you are thought to absorb about 20% of the fat you eat, 60% of the protein you eat, and 100% of the carbs you eat. Your doctor should have explained this to you... The intestines can adapt some to the surgery over time, but most studies have shown DS patients continue to have malabsorption. That's the whole point of the surgery! In rare cases, there is a small number of patients who will lose more weight than they intend, or have excessive muscle wasting. The muscle wasting is normally due to not eating enough protein post surgery. A DS patient needs around 120 grams of protein a day, more if they workout trying to gain muscle. Are you taking your vitamins? Have you had your labs checked recently? In the case of someone who has lost more weight than they intended to with a DS, certain enzymes can be given to help them absorb more of the food they eat, or a surgical revision can be done to lengthen their common channel, giving them more length of small intestines to absorb calories from. Of the two, I'd try the enzymes first. If you gained up to 240 with the enzymes, clearly they were effective for you! So why not consider taking them on an alternating schedule, titrating the dose to slowly gain what you need, and then taper off of them and see if you can maintain?? If you want to do this with food you are probably looking at over 4,000 calories a day. That is going to be tough. You can only eat so much food in a day! DS patients usually don't count calories at all, we count macros because it is the macros that help us stay in our target range, since no one really knows exactly how many calories an individual with a DS surgery is going to absorb, we can only ballpark it. But you should be getting a LOT of protein and around 120-150 grams of fat, according to vets who have lived with this surgery for decades. To bulk, most people I know load up on carbs, which is not easy for a DS person unless you want to spend a lot of time in the bathroom, or you are lucky enough to actually tolerate a decent amount of carbs. But carbs will usually put weight on. If you want more people with DS to talk to, check the bariatricfacts.org forums. We are mostly DS people over there and most of the regular posters are vets. But be prepared, they are fans of straight talk and not everyone likes that!

Hit goal a few days ago, but now I’m worried about the “bounce” that people talk about, so I’m going to keep on for another 20lb. And I actually wonder if I’ll ever be able to STOP losing weight, since I eat so few calories. Still in the 700 range most days. How is everyone else doing?

That suddenly reminded me how much I miss real deal pecan pie. For reference a slice (1/8 of a 9"pie) is; Calories 503 Fat 27.08g Carbs 63.68g Protein 5.98g I'm going to be missing it for a long time!

If you like how you look, feel good, have good mobility, and have no health issues then there's no reason to get this kind of surgery. Doing it because you know you'll gain weight i the future isn't the right reason to do it. Maybe see a nutritionist about getting on a healthy eating plan, and move your body more. Walk, workout, go hiking, swim, do things that move your body. That will help. Pay attention to what you're eating and drinking. Consume 1800 - 2000 calories per day, prioritize protein first, then veggies, then carbs. Reduce sugar and salt. Limit alcoholic drinks. These are all things that will help you to be healthier, drop a little weight, and ensure health as the years go on. Surgery is a last resort for those who have serious weight and health issues and have failed at everything else.

You seem to be on track for that 10 pound regain, which I'm told is normal. You know you ate too much sugar and carbs, so I would start there. Start reducing those until you're back in compliance with your diet. Majorly limit the high calorie cocktails. Move your body more. I would start there. Those are "easy" fixes. Once you're comfortable with that, start getting what, where, and how much you eat back on track. Little by little, you'll get those 10 pounds off and be back where you want to be

That helps but how do I factor in how much I need because of malabsorption. What's the percentage of carbs, protein and carbs that I absorb or we all absorb from ds? I need to know for the information to work for me.. thanks. Or should I just Google it I sometimes wonder how correct Google is when it says I absorb 60% of protein 40% carbs and 50% of calories.. unless that sounds right to you?

According to the American College of Sports Medicine, "To increase muscle mass in combination with physical activity, it is recommended that a person that lifts weights regularly or is training for a running or cycling event eat a range of 1.2-1.7 grams of protein per kilogram of body weight per day, or 0.5 to 0.8 grams per pound of body weight." According to the University of Minnesota, "Recommended Carbohydrate Intake: Research suggests that bodybuilders who are trying to gain substantial muscle growth or increased body mass should consume about 5-6 grams of carbohydrates per kilogram of body weight per day." According to Maxinutrition.com, "Most people require around 20 calories per pound (or 44 kcal / kg) of bodyweight to gain muscle mass. Using a 180-pound (82kg) male as an example, the required daily calorie intake is 3600 calories (20 kcal x 180 lb = 3600 kcal)." Hope that helps (found in a 5 minute Google search). Good luck!!

So how much protein does everyone else eat in order to keep muscle? I expect none of you count calories but you probably pay attention to your protein intake so give me some numbers please... I'm just trying to get to normal. The correct amount to eat every day calories protein carbs. As of yet I have not seen any doctor who could give me that information... I'm looking for a nutritionist who specializes in gastric bypass. Until then just knowing a protein amount to shoot for would help. I'm 6"3 39 ,180 pounds

You should definitely have access to a dietician through the surgeon's office. The problem with any of us giving you that info is that our surgeons all have different requirements. Some allow more carbs and fats, some restrict the heck out of them. Some allow higher calories, some don't. Some universal rules, though, are these: water intake: at least 64oz per day food: PROTEIN first, then veggies, then carbs. Protein, protein, protein!!! sugar: majorly reduce sugar intake (I went to sugar free and use monk fruit sweetener when I need something to taste sweet) salt: reduce the amount of salt (especially if you have high bp) and what I did was switch from normal table salt to Himalayan salt (it's healthier and has a saltier taste so you need less) I don't really want to tell you specifically how many calories, carbs, protein, and fats you can have, because as I said, that varies between surgeons. I can tell you what MY office said and what I do, but that's about it. Here's what my surgeon's office wants: Protein: 60-80g per day Carbs: 50g or less per day Fat: 50g or less per day Calories: first 6 mo - 1000 per day - after 6 mo - 1200 - 1300 per day What I personally do: Calories: non work out days - 1000 per day - workout days - 1200 - 1300 per day Protein: non workout days - 60 - 70g per day - workout days - 80 - 90g per day Carbs: non workout days - 20-25g per day - workout days - 35 - 50g per day Fat: non workout days - 20-25g per day - workout days - 35-50g per day Water: non workout days - 64oz per day - workout days - 64oz of water and 20oz of gatorade zero or Propel per day

First, I'm wondering, why are you having the surgery? It doesn't sound like you're unhappy with how you look, you didn't mention if you have any comorbidities like joint pain, decreased mobility, diabetes, high blood pressure, high cholesterol, etc, and you don't have stats (bmi) that would cause a lot of concern. Second, I've only seen 2 or 3 people on this entire site that have trouble with losing too much weight. Increase your calorie intake, maybe cut the workouts to half, and that shouldn't be an issue. But it's exceedingly rare. Third, you will likely have some regain. It's just par for the course. Not everyone does, but most people do to an extent. If you stick to the plan and move your body, it should be minimal, but it's unfortunately a reality. Lastly, you will shed hair. A lot of it. Most people do. There are a lucky few that don't, but it's a reality the majority of us can't escape. It happened with my first surgery and with my revision. I used volumizing and thickening shampoos and conditioners, cut my hair shorter (it was down to my butt when I had my surgery and I cut it to just touching my shoulders), and styled it a bit differently. And it was fine. Not one person could tell (except me) and once the shedding stopped, it started to regrow fairly quickly. It didn't come out in clumps, it was basically excessive shedding that I mostly saw when I was washing my hair in the shower. It's not like I was losing hair throughout the day and it was all over my clothes or anything.

Well but I'm lifting weights I'm gaining muscle. I do a seca body scan every four to six months and after losing muscle because of a car accident and a year in a half in bed my doctor told me I'm in danger of heart failure so I started lifting weights. But I'm not gaining muscle instead my fat is going down .. so I do understand my body wants to maintain this weight but there is this thing called cutting and bulking and I'm trying to get into a bulk.. Just based off the fact that I don't absorb half my calories I would think of I eat enough calories eventually I'll gain weight.. it can't be impossible can it? I was 19 when I had the surgery 20 years ago. I don't really remember what they told me. I don't recall specifically being told I won't be able to gain weight.. but ok. I'll keep this in mind. Maybe I'm just stuck here. My doctor prescribed my enzymes though he told my my gastric bypass doctor wanted me to gain weight he thinks I should be 190 for my safety 🫤 any more thoughts? I'm still weak my muscle is normal but on the low end still so I can't stop trying to gain weight imo. For my health.

You sound as if you have a great deal going on in your life. You need to take a moment out of your busy life to just breathe. Three months is still a long time to decide which way you want to go, either with surgery or not. You can cancel right up to the minute you walk into the hospital. A few have. This may not be your time. So lets take the things that you are most worried about, Your hair. You will not go bald. You probably will loose some of your thickness. You are young, you have masses of hair. When you are as old as I am you would have already have lost lots of hair due to menopause, so I started off with a deficit. It did get a little scary and I needed to get my hair cut really short but I do love the freedom that it gives me. I felt it was worth it. This surgery was my last chance at a normal life. You will not loose too much weight, you will stop a right place for you. You need to up your calories until you get to a balance. I am ok on 1500 calories a day. I have a slow life, I dont work anymore. I go out with friends, I eat and drink as before. The only thing I do not do is overeat. I don't miss doing that, my friends might do. Especially if they liked to overeat with me. How do you see yourself ? Not how others see you. They may want a fat friend to bolster their own negative ego's. Do you put weight on every year and keep it on ? We all did. We did diets after diets and put it all back on again with added weight. Lots of us ended up with weight related illnesses like diabetes and blood pressure. If you think you can loose weight yourself and keep it off then you need to try. Give yourself 6 to 12 months to do it. Bariatric surgery is not an easy option but if you stick with it, it is a solution. If you do not follow the guide lines then like a diet, it will fail. You should go back and chat with your surgeon. You need to be totally happy with your decision. Give yourself the time you need.

1). there are a lot more people who don't reach goal than there are who lose too much weight. Plus if you feel like you're losing too much weight, you can always increase your calories to put the brakes on it - or to start gaining. So I wouldn't worry about this one AT ALL. 2). fewer than 5% of people are able to lose weight and keep it off. You may be one of the lucky ones who can do that - and if so, and you're afraid of the surgery, it's not too late to pull out and try it on your own. I wasn't one of the lucky ones. I spent my first 55 years as overweight or obese. I gained and lost weight a million times and could never keep it off until I had weight loss surgery. 3). hair loss, if you experience it (and not everyone does), is temporary. I lost hair during months 5-8 post-surgery (so...for three months). It wasn't much, though. I could tell because there were more hairs in my combs and brushes, but I really didn't notice it at all when looking in the mirror, so I'm sure no one else noticed it. Plus hair loss after surgery is more like shedding - not huge clumps of loss like one might have after chemo. For a lot of people, they're the only ones who notice it. It's usually more loss of volume than noticeable "bald spots" - and it does grow back. to me, the risk of losing some hair temporarily vs. being morbidly obese for the rest of my life was a no-brainer. But you may think and decide differently for yourself - and there's nothing wrong with that. If you're not mentally ready for this yet, or want to try on your own to lose weight, then there's nothing wrong with canceling or postponing your surgery. You wouldn't be the first..or last.

Regain is a fear I think we all carry with us. In addition to @Spinoza’s advice, make sure you restart tracking your food intake, fluids & activity too. It can be easy to let portion sizes slip, reintroduce foods that aren’t nutritionally dense & are calorie heavy, life gets busy so you drop or reduce any activity you were doing ir simply life throws challenges at you so watching what you eat gets forgotten or put in the too hard basket. Get back in touch with your team too: your dietician, therapist, etc. To talk through what’s been happening, any emotional, medical or psychological challenges you may have been facing, why you revered to old eating behaviours, better food choices etc. & look at ways you can better manage these considerations. Even meet up with your surgeon to look at what other options are available to you too.

I am just now starting the journey and trying to get used to dietary changes. The guidelines I was given them were very very broad in general, and I kind of like a more specific idea of what I need to change and what my calorie account should be in my macro should be, and that really wasn’t given to me so I’m struggling. Is there anyone who has any tips and tricks for dietary visions while I go through the approval process?

So I eat 4200 calories a day. Long story short. 456 pounds at age 19 had DS 39 now and I weigh 178 pounds I've been working out 3x a week for two years. Lifting weights. At first I lost muscle, because I was eating 2200 calories most days maybe 60 grams of protein. I now I eat 4200 a day and get 250 grams of protein easy but even with gaining muscle I don't gain weight on the scale yet. I've gained in the past but once I started lifting weights I stopped. I just stay at 178ish.. my doctor wants me to take enzymes but I want to be able to gain weight with food... It's annoying to me I can't even gain a pound. I'm slowly raising calories 200 at a time. I wait a month then I'll raise it again but does anyone know how many calories I probably need and can anyone tell me for sure how many calories I absorb and how much fat, carbs, protein I absorb? My doctor says he can't tell me because everyone is different but... I need answers. I find myself scared every day I'll lose weight.. it's crazy to me im eating so much but my doctor's kinda not cool.. so I don't trust him last time I took enzymes I ended up getting up to 240 pounds on accident and the idea of gaining that much weight scares me.. I prefer to do it normally I just wonder what the calorie number is need. What works for you

no, weight loss doesn't stop on x date. it stops when YOU stop. it may take more effort as time goes on - because achieving calorie deficit is comparatively more challenging the smaller u get - but its not impossible. good luck! ❤️

The best option would be to contact your old bariatric team. They can set up a comprehensive diet and give you guidance on what and how to kick start your new plan. If for some reason you can't do that, look at how and what you've been eating, cut back on calories, carbs and fats. Are you going over the maintenance limits? Its the same rules as before you had surgery: less calories in than you burn off. Go back on a reduced calorie, carb fats diet.

Most meals are between 300-500 calories each except the sushi was like 250. I’ve been eating a lot of eggs the past week but am definitely not doing the egg fast diet again! And most of these “meals” are things I pick at for a couple hours. Today’s lunch (the last picture) I made at 3pm and finished around 630pm. It’s roasted butternut squash with sautéed kale, garlic, onion, and shiitake rice.

Hello All- i posted for the first time just about three years ago with some anxieties as a spouse with my wife prepping to undergo the gastric sleeve. I originally noted being concerned about our lifestyle changes, relationship impacts (I had heard all the horror stories) and most of all health concerns into the future. The community was incredibly supportive and I had learned tips and useful knowledge that helped me coach and support my wife through it. I am happy to say we are better than we ever have been and her self confidence is through the roof. However the MAIN reason the surgery ever was even considered was to get her diabetes that started while she was pregnant with our first child and got very concerning bad with our fourth has still stuck around and caused issues….. First- this is Life changing not just for the partner getting the surgery, but the spouse too. We used to be foodies and that all had to go out the door. Same with alcohol. Two bites and you are full, a pint and you are drunk. So activities, dates, etc. and new hobbies should all be prepared for well in advance. Luckily we are both athletes and coaches and this allowed to have an outlet that wasn’t our prior foodies and beer/ brewery culture pastime. Two- Relationship, anyone who tells you that this leads to automatic divorce/ break up is paranoid or lying. Out of her support group offered by our health network, I think only 1 or 2 of about fifteen women ended up separating and that was from the other spouse cheating. I have to say that in many ways, after four kids and all our activities, youth sports and coaching- it created a second honeymoon period for us and really strengthened our romance and relationship because we both focused on our health again jointly and the magnetism increased dramatically. Third- It might not fix the problem…. We did not jointly go into the surgery for cosmetic or weight loss reasons. It was the diabetes and the doctors said it was a solid shot to cure or mitigate the disease. It was for a while, but it keeps back up. despite healthy eating, despite exercise and coaching, despite the surgery- medications came back into the picture and so did the celebrity weight loss drug (which is really supposed to be for diabetes…) This has been keeping everything under control but is a case of the cure being as bad as the sickness. The side effects are brutal and definitely have a quality of life impact, but we both want to live to see grandkids someday….. Fourth- dysmorphia is VERY really. We are both naturally larger people. I was a lineman in high school and college and she was a softball catcher in high school and college and ended up also playing women’s rugby there as well. Even with the surgery she went from an XL to L but she got her college/ high school figure back and as such her confidence went through the roof and started dressing like she hadn’t in years. With the medication though??? Her figure, face shape, everything changed. Down to a Small or Medium. For almost a year and a half she hasn’t recognized herself in the mirror. It’s a double wham with the surgery and the medication. Between her best friends and myself (we have all been in the same friend/ team group since college) the support was to have fun with it and go with the flow. Instead of worrying about it (the dysmorphia) it was embrace the change. All new clothes she could never wear before, she’s been a redhead now and then blonde and still is. Cut her hair shorter, started wearing makeup (never really did)- all just to try and put a positive spin on it. I’ve been the spoiled recipient of having a brand new girl (don’t think I haven’t romanced and spoiled the you-know-what out of her), but at the end of the day it’s been mitigation of all the life changes. The last part has been the most detailed because it’s the most recent and to me has been the most impactful- NOT having the surgery do its intended purpose and the dysmorphia we’re both very difficult given the efforts and life changes made. We’ve done everything we can to make lemonade out of those lemons though. We had an anniversary vacation better than our honeymoon this past summer (she has always been way out of my league and these days it’s very much over the top- I feel incredibly spoiled) and we have made time to ride our bikes together with our oldest babysitting the kids and we come to each others games when we coach. I would tell any spouse; husband or wife of someone who is going to have the surgery and then or also do all the meds: 1. Support. It’s a huge deal and you need to show up. 2. Don’t get insecure about your relationship because of the surgery. If you are worried it means you might not have a great relationship to start with…. 3. You will need to change your life too. Because of my size and my weight lifting, I need a lot of protein and calories. I will never look like a Hollywood star (like she now does) and always an NFL lineman- BUT- if I bring a cannoli, pie or a full growler into the house in addition to steak/ salmon, etc it’s teasing and not fair. You will need to learn self control to support your spouse… 4. Inspire and come up with ideas for positive re-enforcement. If the dysmorphia or depression sets in, you need to find fun things to do, supportive steps to take and positive angles to keep things going. 5. If you are doing all this as a spouse, what about YOU??? Are you going to die a martyr? Take care of YOURSELF too. I go lifting 3 times a week, go fishing in season. And for my 40th birthday when she asked what I wanted?? I got us a long weekend on the Cape, bought her some dresses I wanted to see her in and sent her to get her hair, nails, toes, eyelashes, etc.. done. Said I wanted a long weekend with my movie star wife. It was a great time, kid free and continued to strengthen our marriage. Anyways- why am I writing this? Posterity? Self reflection? Not really…. I just want to give Spouses a roadmap. It’s a huge change and you need to navigate the waters well. If you do you will benefit as much as your loved one. Good luck.

Is anyone tracking calories and carbs 1 week post op? If so, what is your calorie intake? I am under 300 but wanted to know if anyone else is tracking.

Get some vitamin water. Preferably the diet one. Low carbs and calories. The lemonade was the best one cold.

300-500 calories a day at 6 months seems low, at least by my bariatric teams outline and booklet/plan given to me. I'm at 4 months and eating regular food at 800 per day. I'm told its right on track. Have you spoken to your doctor/dietician? Perhaps do as I was told instead of three meals a day - have 5 small meals to get you to where you need to be? Either way, I'd check with your doctor.

I still feel my restriction at more than 4.5yrs. I don’t feel it as often & it has softened a little but I think that is because I’m more aware of my portion limitations & when I’m nearing that point of not being full but having had enough, I stop. I was a low calorie eater barely eating 900 calories at 6 months & took another 11months or so to get to around 1300. Though you seem to be quite low. Have you spoken to your surgeon? If not I’d make an appointment to see what they suggest & ask for some testing to be done.. You may have a stricture, your esophagus maybe over tightening, the boogie may have been too narrow, etc. Generally these are easy to remedy usually via an endoscopy if this is what is happening. All the best.

It’s been 6 months - is it normal to still have a very strong restriction? I still can only eat small meals like crackers, soup and I hardly eat. I just had two hits of tofu and some bean sprouts and I am stuffed! I have lost all the weight now but worried I’m going to go the other way. I’m consuming 300-500 calories a day. Help?