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Great advice above by all. I wanted to add that sometimes people think there's something wrong with them or with the surgery, but what you're feeling is absolutely normal. Sure, some of the things you're feeling might not qualify as "true hunger", but that distinction is sometimes not nearly as clear as some people make it out to be. Much of what we call head hunger is due to hormonal responses not unlike those generated by actual hunger. This can be especially true when we're in a significant calorie deficit, like you are in right now. My point is that your body is designed to do exactly what it's doing, so don't beat yourself up for it.

At the end of the day, it is calories in vs calories out. If you are eating less calories than you expend, you will continue to lose weight. Those calories can be from cookies or steak... the benefits from what your getting from those calories is the difference. Ask yourself, am I getting a balance of all the vitamins and nutrients that I need from food? If you had a day where you ate amazingly healthy with variety, a cookie is probably not going to hurt.

Well there is never a 100% guarantee because we are all different but I would say that your response so far makes it very likely that you will be a success story based on my personal experience and the knowledge that I have of others experience who have lost and kept it off vs those who have regained a significant amount. I had my sleeve surgery 3/9/2021 so I have been on these boards since then and I have been going to in person support groups since a couple of months prior to my revision and my personal experience and learned experience is that one of two four things happen to cause regain. 1: the person never really does change what they eat. This is a problem when the anatomical changes control portion of less nutritious foods for a while so they lose some but then as the stomach stretches they can eat more and they regain or they are able to have just a taste of things in the beginning but when appetite comes back that changes (note that some people can have just one bite of a brownie forever but that didn’t work for me so we just have to be mindful of how our body reacts and stop doing it if we can’t stop ourselves at a small portion). 2: the surgery was never a good fit. I know that this was part of problem with the sleeve for me because I never did feel ANY metabolic changes. I still absolutely hated healthy foods that I didn’t like before and I did not have any additional energy or motivation after the surgery. Basically I think for me the surgery was probably like Wegovy would be. The hunger hormones went away for a while and I was able to eat less until that came back. But nothing else changed for me. I never felt a change in energy and I was never about to get start r with exercise and healthy food options did not appeal to me in the slightest. I ate alot of chicken breast and a few veggies that I don’t mind in the beginning but there was no variety so like most diets I couldn’t sustain it when the hunger came back and I wasn’t moving my body to help my physical and mental health to keep it going. 3: This would be a combo of the two which would be where i would actually say that I fell with my sleeve. Because I didn’t like enough of the healthy food even a little bit I started having less ideal foods far more often. I mean i wasn’t eating McDonald’s ever and I wasn’t having poor choices all the time but I would have like a quarter of a frozen pizza or a lean cheeseburger with a roll several nights a week thinking it was okay because calorie wise it wasn’t much worse if that was all ate. The problem was the other macros and the fact that for me they were slippery slope foods and they made me crave more. I wasn’t gaining on that but carbs make me crave carbs so that little devil voice took over and I tested the waters a bit more by having just a few fries or a bit of cake with that but it was way too often and far too early out for me to know my limits. Then, to make matters worse, my mental health issues kicked in where I had not only stopped losing but gained 20 pounds and when I couldn’t reverse it even when I tried my hardest to rein it in (because I was now craving the carbs again bad) i just considered that I was a complete failure and they didn’t say it but i could see it that my friends and family felt that way too and I just slowly just quit trying. This is when the support of people who get it would’ve been sooooooooooo very important. Never been obese people are never going to be able to get it or be able to help. Reach out to your bariatric support if you struggle. Even if your disgusted. They get it and never judge. 4: Some people even though the surgery is a success and they make all the lifestyle changes and everything is working lose sight of their lifelong goal for one reason or another and let bad habits slowly slip back in and they gain. I think this is probate going to be the hardest one for me. To not take my eye off the prize 5 years down the road. But we can do it. I think that staying active in these support groups and checking in with my team is going to be key for me. I am going to ask to have my follow ups a couple times a year even when I’m a ways out just to keep me in check. I know that I am able to gain a lot of weight in a year!! I never did the In person support groups at all after my sleeve and I stopped posting here for a while and didn’t go to my follow up appointments when things were out of control and I needed the help the most. Basically for me the sleeve was just one of my longer and more successful diets that started with the curved appetite and a lot of hope that it would work this time but slowly ended when the hunger came back, bad habits slipped back in, the cravings got unbearable and my all or nothing thinking finally got the best of me. I think I probably would have leveled out somewhere between my starting and my low weight if I had not given up but since I started at a relatively low BMI to begin with that did not seem like a success to me at the time. 89 pounds later I only wished I had been back to that weight though. I learned a lot from the sleeve experience though and I think that knowledge is helping me now. Hopefully, it helps others too. I try to let my experience be a cautionary tale without scaring anyone too much. Anyways, based on your nutrition changes, steady loss and your activity I do not think you are like me with the sleeve or others who I’ve seen who never even tried to eat differently or exercise so I don’t think your surgery was a bad fit at all or that your just expecting the surgery to do all the work. I think that your surgery is doing what it was designed to do for you and so as long as you keep doing your part you should get your where your body needs to be. Just don’t get caught up in a certain number and let your brain get the best of you like I did. That last 10 or 15 pounds may feel like a lot but your already so much healthier and happier that you were before. Keep striving for that goal but don’t let it be the only thing that matters. To me it will be icing on the cake to what is already a success story Your body will have its own idea of what is an ideal size for you and you may have to just accept that it may not be exactly what you have in mind (it could be lower but it could also be a bit higher. It may be a sorry to accept where your body is happy and healthy if you don’t want to be really working hard at this forever. Honestly, I imagine we will have to work at it for the rest of our lives to some degree. By that I mean that we will probably never have it as easy as someone who has never been obese. You are doing so incredibly well, though, making actual lifestyle changes and I have listened to anyone who is willing to share whether they were successful or not and that seems to be the biggest piece of advice. This is not a diet it is a lifestyle. Your surgery is working for you and you are working hard for you as well. Those two things are key to this journey long term. Just keep it up and I really believe you will reach all of your goals. ❤️

You need to schedule and appointment with your surgeon (or his or her NP or PA) if you really are weighing and measuring every little Thing and only getting 800 calories you shouldn’t be gaining but something is getting missed. It could Be medical or you may be missing something in your count. Either way it sounds like this dietician had already made her mind up that there is only one possibility and she probably isn’t going to be the one to help you get to the bottom of things. Make an appointment with your team and start taking pics of all of your food so you can show them exactly what you’re eating everyday. Make an album with all the food pics and hand them your phone so they can scroll through and see for themselves. When I regained after my sleeve. I was embarrassed to go back to team and thought they were going to be so hard on me and when I went back, I realized I couldn’t have been further from the truth. They were so open and compassionate and understanding and all they wanted to do was help. Obesity is complex and they realize it. They go in this field for a reason. They may not get to the bottom of it in one visit. It may even take a few, but trust me it’s worth.It. Don’t give up.

I forgot to post. But according to my dietician I am over eating, they say this is the only way I am gaining weight and that it has to be a surplus of calories. I only eat once a day because of this and I now eat lean meat only. So if this does not work than I quit.

Congratulations on your loss. I was a savory girl Lee bariatric world and post sleeve I became a sweet girl too. Then post SAFI that went away but has started to come back. I think MAYBE it’s just our bodies wanting carbs and sweet food is usually the absolute highest in carbs so the quickest way to get them. I did not have the bypass but I don’t think your friend is correct about eating whatever you want. I know that was for sure not true for the me with the sleeve. I started at 235, lost down to 168 then gained it all back plus some to 258 and was still gaining when I started the preop diet for my revision. I have also heard plenty of regain stories on here about the bypass. Now, does it malabsorb some of your food, absolutely. So if you were like 900 pounds before it’s possible you would stay a bit smaller just because you pretty much already ate all you wanted volume and calories wise before and the malabsorption would in theory make you weight a bit less if you ate the same exact food, but it would only be a bit less anyways and who of us wants that. . As far as a more common starting weight I really don’t think so because even at our high weights we still weren’t eating absolutely all we would have liked to or we could have and if we ate any and everything we wanted, even with some calories not absorbing that’s still probably giving our bodies more than we were eating before. I do know from experience that what fuel I put into my body changed how I feel, though, so even if I could get away with eating anything I wanted cosmetically, I know that I wouldn’t feel as good as I do when I eat a balanced diet and keep up my activity. That processed junk that most of us used to eat all the time is not good for us and it doesn’t give your bodies what it needs to run efficiently. Another thing to keep in mind is that we are still pretty early out to be relaxing too much. Most people have a 10–15 pound bounce back even if they keep working at it. I don’t know about you but I’ve still got more that I want to lost. I definitely don’t want to be bouncing back!! for the sweet cravings try the sugar free popsicles again. They can trick my brain sometimes and others i Have fruit. I figure calorie wise they may be more calories but at least it’s not added sugar. I try to avoid that as much as possible because that makes me have more cravings the next day and for like a week.

The simple answer is yes. Just getting a small stomach does not cure your brain. It is hard wired to feast whenever there is a glut of food and unfortunately that is what is all around us these days. I waited 30 years for this surgery so this is me - I allow myself 1500 calories a day. I religiously track them I could easily eat around my sleeve, I love chocolate and dont have any will power. If I open a bar then I eat it. So I buy the packs of tiny 25gram bars. I have increased my activity. I walk everywhere. I shop better for quality protein rich foods and menu plan, You may find when your new stomach has healed, about 6 - 12 weeks out, you will hopefully feel your restriction kick in. You should feel the full signals. Certain foods fill me longer than other. I physically can not eat or drink for two hours after eating meat. Mince it and I can go again after an hour. Its a massive learning curve.

The ONLY thing you have to do to lose weight is eat fewer calories than you burn. If you do that you will lose weight. There are lots of tools we can use to help us in this regard, like tracking, meal prep, tweaking macros, eating more high quality foods vs. junk food, and a lot more, but at the end of the day, it's calorie consumption that will make or break a diet. For some people tracking is critically important because if they don't track, they overeat badly. Everyone has a bad tendency to way underestimate the number of calories we eat in a day, so especially for people that tend to snack a lot, or eat a super varied diet (which is not a bad thing!), then tracking at least sometimes is pretty helpful to make sure they don't overeat. Like you, I just can't track reliably. It's not so much that I forget to do so, as much as I find it incredibly time consuming and boring, thus I just don't do it. Would I love to be able to track calories consistently? Sure. Really honing in on my daily calorie intake appeals to my analytical mind. I know I'll never be able to do it though. At this point, what I try to do is "spot check" my calorie consumption here and there. Sometimes I might make it a whole day and sometimes I just evaluate a single meal. This helps remind me to keep things in check.

Great ideas above but if that doesn’t work for you or for others reading this later, What if you were to just divide your alloyed macros or calories into meals/snacks. Like if you were allowed 1200 a day you do meals around 300 calories and 3 100 calorie snacks. For macros just don’t routinely eat any food over X grams of fat or added sugar. You can break it up differently. I did a protein shake for breakfast so I could have what felt like a little more substantial lunch and dinner. It should’ve be as hard forever. Once you figure out a handful meals that are within this plan you most likely will just sorta remember what meals work. I know I did and I live my life by alarms and reminders. Sometimes I joke that if my alarm didn’t tell me to wake up one day I just may not…ever. That’s how reliant I am on them. Anyways, I have a handful of my common meals that I know will work if I don’t have time to think about things. And if I’m having a less ideal lunch then I already know it’s chicken breast of fish for dinner with a veggie. Every meal for me has protein unless it’s a real odd day out and then I do my best to make up for it with a Greek yogurt or shake for snack. Another option would be to do the guess work the night before and pre plan what you eat the next day. You can play around with options and log it all into Baritastic or another calorie tracker app and know if it fits you plan and then just eat what’s on your list the next day. That may actually take a little stress out of it as well just having the decisions already made the day before. The meal prep mentioned before seems like a great way to achieve this as well. I know that I have single serve meals like that in the freezer. My regular and chicken chili are really great because they can even be defrosted in the microwave so they are good for days with zero planning or time.

I am here to add my vote for meal planning. I also have ADHD tendencies and I LOATHE food tracking. In the early days after surgery when I absolutely had to make sure I got in my protein and water, I managed to track by keeping a physical tracking notebook next to me at all times. I had to see the book to remember to do it. I stopped tracking around 5 months when I was consistently hitting my goals. Now that I am almost a year out, my weight loss has slowed (as expected) and I am finding it too easy to make poor choices if I don't plan ahead. I forced myself to actually track for a couple days and was shocked by how many calories I could eat and what I was choosing even when I "thought" I had been pretty reasonable. So, instead of tracking, which I am still terrible at, I've started meal planning and prepping ahead. For breakfast and lunch, I came up with a selection of maybe three or four choices I liked that have around 20g protein and entered them into my meal tracking app. For example, a spinach frittata for breakfast that I can slice into several servings, fruit cups that I make ahead for the week, single-serve packets of protein oatmeal or a protein bar for those days when I have to grab and go. For lunch, I make homemade chicken veg soup and also salad jars. I also like to make a batch of turkey chili to have on hand, which I store in single-serve containers. I also came up with a few snacks I like such as Greek yogurt with blueberries, or an apple with cheese. I also entered in my typical favorite 6 or 7 homemade dinners as recipes or meals in the app so I could easily add them to my day with one click. Before my shopping day, I try to plan my meals for the coming week. If I see my calories going too high or my protein not being enough, or whatever, on any given day, I can adjust accordingly. On a day that I eat oatmeal, I make sure my other choices are less carb heavy. If I have eggs for breakfast, I might plan to have a carb at dinner. I have the tab easy to get to on my computer, but printing it out each day would also work, as would entering each meal as a reminder in your phone's task list or calendar app. It is so much easier for me to look at my menu and follow it than it is for me to decide what to eat every day in the moment. It also means that if I can eat what I plan most of the time, I can have a restaurant meal or a dessert a few times a month without worrying about it or trying to track it. And since I tend to package up most of my make-ahead meals in single-serve containers, it's pretty easy to grab something to take along if I'm going to be out and don't want to have to hunt for food on the go and risk being off plan. The worst days for me are when everything in the house is an ingredient instead of a meal. That's exhausting and inevitably leads to snacking or poor choices. I find I need to set a regular day of the week for shopping when I can also have time to prep some items right away, before the food even goes in the fridge. I have the most success for the week when all my produce enters the fridge already washed, sliced, and portioned into fruit cups and salad jars, and when I can kick off a batch of chili in the slow cooker, a frittata in the oven, and a batch of taco meat to store for later in the week all at once. Freezing complete single-serve meals is another great strategy for those busy days when you might otherwise get off track. Like any habit, it takes a while to establish and may not be 100% perfect all the time, but I definitely find this helping me.

I am a tracker and I have ADHD so I have to meal prep and I track most my food (breakfast, lunch and snacks) for the week once I am done meal prepping. This is kinda crazy I know, I use mynetdiary, I have it on my phone and you can access it on a desktop which is important for me so I can look at it while at work. This leaves me my calories for the day so I know around what I can eat for dinner and a dessert if I want (which I always do like a sweet treat to end my night LOL) I am a little over a year out and I feel like tracking keeps me focused, I am not comfortable not tracking yet, its something that keeps me focused. I even track on the very high days. Like on my birthday, I tracked it was NOT pretty but I tracked it.

It was a big shock to me that I wouldn't loose every day/week after my surgery. I also asked on here and the answer was, You will have stall weeks and the further out you are the longer they will last. You can't break them by diet or exercise, you just have to be patient. I eventually got used to it. The fact that you have a different type of tool will not make a difference. You are eating a very reduced amount of food, 800 calories. You are in a huge deficit, remember that. Weight loss is inevitable. Like everything else in life, it does not happen as we dream it to be. It is highly annoying though. As long as you are tracking your food and drink and are moving more every week then you can't fail.

Not to dis on your friend, but that's just not how this works. The ski slope chart itself may be about what your weight loss looks like for many people, but I promise you, you are losing fat the entire time. You just can't overcome basic physics. Think about it. If you eat less calories than you burn, your body has to make up that difference from somewhere. Even the leanest people on the planet have something like 40,000 plus calories of fat stores. This is what your body uses to stay alive when intake is less than output. Do the math: Your Total Daily Energy Expenditure (TDEE), is made up of your Resting Metabolic Rate (RMR), your Exercise Activity Thermogenesis (EAT), and your Non-Exercise Activity Thermogenesis (NEAT). The average normal sized person has a resting metabolic rate somewhere between 1200 and 1800 calories. It's even higher for overweight and obese people. This is just an estimate, but yours is probably somewhere around 1900-2000 based on your height and current weight. EAT obviously can vary quite a lot from basically nothing if you don't workout, to well over a thousand calories per day if you exercise a lot. NEAT is important as well. The basic idea is that very few of us are completely sedentary. We are moving around cooking, cleaning, doing chores, etc. This is what we sometimes call "Activities of Daily Living". This tends to add another 15% to 20% to your overall calories for most people. The point of me adding all that is because very few people really understand how many calories their body needs per day just to stay alive. If your body needs 3000 calories per day and you are only consuming 800, then the rest of your energy needs for the day have to come from your tissues. If we do things right, the vast majority of that will come from fat, though no matter how hard we try, some of it will come from muscle tissue. Regardless, (and here's the point of all this), there is never a period of time when eating a very low calorie diet like we do after bariatric surgery, when you just lose water weight, or stop losing fat. Early on, you will lose a lot of water weight, but what you are losing is not JUST water. Later, you may experience stalls, but that's not a period of time when you stop losing fat. Instead, you may be putting more water weight back on (this IS part of the healing process), but you're still losing fat underneath that water gain. Note that there will be other times when your weight plateaus or even goes up some. This is 100% normal and not a cause for concern. If you are following the diet plan your surgical team sent you, you WILL lose fat. It's impossible not to. This is why I said it's just not healthy to weigh yourself daily. Scales LIE. They don't measure our amount of fat loss, they just measure weight, and weight is made up of so much more than just fat.

I had the Orbera 365 inserted 2 weeks ago. In the first week I lost 3 pounds and this week I haven’t lost anything at all. Is this normal? I am eating around 800 calories and walking 30 mins a day. Has anyone else had the same experience? Thanks

Hi, sorry I have been absent. I was sleeved a week ago today. I stayed in hospital two nights and didn't have any real problems. Liquids went down pretty easily and I got 1litre in on the first day and the drip was taken off that afternoon. They left the cannula in and it started bleeding - it was in my elbow bend and I think I did something when I bent my arm too quickly - so they took that out too, which was great! I tidied up my room, put on clean clothes and took it easy. I even got let out for a couple of hours to visit my father-in-law in the public hospital next door. He is nearly 90 and the end is coming - they thought it was close on Tuesday although he has picked up a bit since then. Slept intermittently the first night and rang the bell for pain killers a few times. The second night I slept fine - but they woke me up for obs at 11:30pm and 5:30am! Ugh! Then I went back to sleep after the 5:30am ones and my surgeon woke me at 6:30am! I gave up after that My husband turned up 9ish so I got up and showered, dressed and packed and was sent on my way with Palexia (opioid painkiller) and a reflux medication. We went to visit FIL for an hour or so then got an Uber to our short stay apartment. I had to go to Sydney for surgery - I live in Canberra - and the doctor said I should stay in Sydney for four more days. So that was Thursday, day 2 post op. I didn't do anything else that day. Friday was ok, I'm not having any trouble consuming liquids although plain water is the hardest - it gives me a temporary lump in my chest and sometimes hiccups. One thing that really bothered me on Wednesday and Thursday was that when I lay down to sleep at night I felt like I had a tennis ball in my chest. I had to sit up for a while. The surgeon said it is common with the surgery and I also had a small hiatus hernia repaired and it can be part of that too. I found that not taking tablets and drinking water immediately before lying down was best but I haven't had it since. Saturday I hit a wall mentally. I think it was a lot to do with being away from home - I always feel a bit "wrong" away from home but usually I'm travelling which means (a) fun (b) eating and drinking what I like and of course post surgery none of that was happening. I went for a short walk with my husband in Hyde Park Saturday evening and it helped a tiny bit. I felt really depressed and like I'd done the wrong thing and that I'd never lose weight etc etc. Because I'm autistic I had a couple of autistic meltdowns at my poor husband who copes with them quite well. So unfair, he was doing his best to look after me. Sunday I said I didn't want to do anything but after a while I said to him we should go for a walk. Unfortunately it was hot and humid in Sydney (Canberra has an inland elevated dry climate so I don't do humidity well), but we went out for two hours. I had to sit down a lot - no energy plus the humidity ugh - so it was slow and I only did about 5,000 steps but it was a good thing to do. We walked through Hyde Park, down to the Art Gallery, through the domain, up to Macquarie Street, round to Circular Quay. It was Australia Day so there were heaps of people out, which made me nervous about someone walking into me and hurting my incisions. We had lunch at the Quay - fish and chips for him and a banana smoothie for me - I ate the tip of a chip with aioli but I chewed it to death first, and chewed some fish and spat it out (I know, gross). We caught the light rail back up to Town Hall and went "home". He went back to visit his Dad and I watched YouTube videos and even edited one of my own (I have YouTube channel on, don't laugh after what I said about being away from home, travel). Monday we packed up and came home. The relief of being home! I still felt a bit funny bit it wasn't too bad and last night I gave the kitchen and butler's pantry a really good clean so I was obviously feeling a lot better. Our cats (6) sit all over the bench and leave hair and dirt so after a week of being away it was pretty grubby. Plus my husband cooked me some soup and he is messy to say the least. Today I'm back at my desk getting on top of things and having that shower in my own bathroom was unbelievably good. I'm shaky and weak this morning so sipping on an Optifast shake. I've been tracking food in My Fitness Pal. I was craving hummus for lunch yesterday - I saw it in the Qantas Lounge on the way to the plane haha - so when we went shopping for food I bought a tub and ate half of it for lunch. Then I tracked it and the calories are unbelievable! I thought it was mainly chick peas but the half a small tub was about 850 calories so I won't be doing that again. Michael is going to make me some and put only a tiny bit of oil in it so it should be a lot lower in calories hopefully. I hope all this is of some use to others about to undergo this procedure! Or else I've just been rambling to no purpose I think I can start puree today but tbh I've been eating thicker stuff like hummus and yogurt already.

@ShoppGirl I am a super Type A, and research Nazi before I do anything LOL I have looked into all the risks, it took me entire year to even make the appointment with my doc for the sleeve and then I have been looking into a breast augmentation for a couple of years. The risks were what scared me, but yes I got the gummy bear implants so the risks are lower than saline for a leak. I will absolutely give you all my tips and tricks when your down and out as well! And yes, I have been having fun shopping and trying on tops that shows off the girls LOLOLOL @SpartanMaker I will definitely check in, I am taking everything into account of all the advice. When I do workout I am easily eating 2100-2400 and I stayed on the lower end of my end, but the range gives more flexibility. I know when I was so strict on my calorie goal that I set for myself I was over obsessing with it and I was falling into the other side of the spectrum of a really toxic relationship with food which was to avoid it and not eat. I am trying to find that happy medium, its taking time but I am getting there! I am hoping that on Friday for my appt it will be 1month post op and he gives me the go to at least do cardio! fingers crossed!

I still drink them at 17 months post-op - 1 a day. That being said you can give them up at anytime as long as you can get your protein in other ways. I personally find it easier to assure I'm getting my daily protein in by including Fairlife, but I'm still only eating 800 calories a day which makes it difficult getting 80grams of protein so they help. Yes, they're a pain to get and $$. I finally just decided Amazon auto ship subscription works best for me. You can just add protein powder to every thing you eat if you want.. 😁

@AmberFL Thanks for the additional detail! I agree with @ShoppGirl that localized swelling and postoperative edema may be causing a lot of your gain. I do also totally understand the concerns, though! I recently had a procedure done on my proximal hamstring to treat a partial tear. While not nearly on the same scale as your plastic surgery, I wasn't able to workout at all for a full month and even now almost 2 months later, I'm still having to ramp back up really slowly. For example, I'm still not allowed to do any lower body strength training and my running mileage is only at about 50% of where it was before the procedure. Like you, I also saw my weight go up during this time. Even though I knew edema was the likely initial cause, it still messes with your head. This was especially true for me because my workouts are frankly a form of therapy for me. It felt like a double blow. It really sounds like you've got the diet mostly dialed in for now. I suspect one of 2 things will happen as you heal. The most likely eventuality is that your swelling and edema goes down and you find you're happy with where you're at weight wise. If so, be sure to up your calories as your workouts resume. If you find that you are a little heavier than your ideal, then no worries. Once you are working out again, the easiest solution would to only eat back about 50%-75% of your workout calories. This will be slower, but is super sustainable, compared to a drastic cut in calories that would get you leaner quickly, but is also a lot more likely to cause some rebound weight gain. I also noticed something you said in an earlier post and I wanted to commend you for it. You mentioned something about maintaining around 1700-2000 calories. This is something a lot of people don't understand, but you can successfully maintain across a range of calories. Many people think they've got to be EXACTLY at a certain number to maintain. That's just not true. The reason is that most people will subconsciously be a little more active when the calories are higher and a little less when they are lower. Please check in every few weeks and let us know how it's going? I'm sure you'll do great, be we are always here to help if needed.

@ShoppGirl I hear you. Yes I saw the articles from HSS and a few others that quoted that amount, but I've found that sometimes things like this often become an echochamber, even among doctors and other healthcare professionals that should know better. All it takes for this to become the "standard", is for a 50 year old medical textbook or two to print this (based on old data or beliefs), and an entire generation of doctors come to accept it. Look no further than BMI as an example of a well meaning, but ultimately wrong calculation becoming the standard by which we judge obesity and you can see how this sort of thing may not be based on science, but on "generally accepted knowledge". Back to the subject at hand. We do know that RMR can and does increase during recovery, but the amount is not always the same and is highly dependent on both the injury/illness, as well as the individual themselves. As a general rule of thumb when talking about athletes like @AmberFL, the number of calories needed during recovery is typically a little higher than maintenance, but quite a bit lower than what they might have needed when working out. That said, we also need to recognize that Non-Exercise Energy Thermogenesis (NEAT) can vary by many hundreds of calories between individuals. This is important, because even though RMR may increase, it's logical to assume people will have a concomitant reduction in NEAT when ill or injured. The net effect of that may mean the calorie balance may not really change that much if at all. Here's an example: Let's use a 3 factor calorie model, meaning RMR, NEAT & Exercise. (I'm going to ignore TEF for now since it won't make a lot of difference here). Let's assume an RMR is 1500, since this is around the average for all humans. Let's also assume a NEAT of 600 for a total calorie burn before exercise of ~2100. I've selected this since it also is fairly close to the median. Obviously these are just averages and every individual will be different. At an RMR of 1500, if we use as an example a 25% increase due to illness/injury, that would mean the new RMR would be as much as 375 calories more. We would expect NEAT to drop in most people when ill or injured because they tend to sit/lie down a lot more, walk less, etc. Especially in people that have a high NEAT amount to begin with, a drop of 375 calories per day or more is easily within normal ranges when they don't feel good. The net result in our "average" person here is that while their RMR went up, their NEAT went down by the same amount, thus completely negating any need for additional calories. At the end of the day, like you pointed out, we all have to decide for ourselves what we believe and what we think is right. I'm certainly not opposed to anyone consulting with their doctor regarding nutritional needs, as long as you recognise that most doctors get, at best, a single course in nutrition in medical school. Many get even less. I'd tend to suggest a Registered Dietitian instead, especially when dealing with chronic or acute injury or illness. Full disclosure, my background in this area is in nutritional needs for athletes, not people that are unwell. The flip side of this is that I find there are very few RDs that have the requisite knowledge to properly coach athletes, since so much of their training goes into how to help with weight loss, or assist with the nutritional needs of diabetics, cancer patients and the like. We also know that there are some really lousy RDs out there as well, so caveat emptor. (Otherwise, why would we see some of them trying to get very active bariatric patients to stay on an 800kcal/d diet.). Any RD that does that is, i'm sorry to say, an idiot. I'll close by saying that I don't doubt you in the least that you needed to up your calories by a significant amount due to cancer and chemo. I'm sure you recognise that's really in a different league to what most people are going through when recovering from an injury/illness or even surgical procedure. In your case, you have both the fact that cancer cells are effectively using calories that should go toward healthy tissue, as well as the fact that chemo is incredibly destructive to the rest of your body. Best of luck.

Some programs want their patients to avoid them as soon as possible - within the first few months - on the premise that they don't want their patients drinking calories and would rather they work with solid food instead. Most programs don't care, but there is some merit to the liquid vs. solid argument, at least for a time. Many, OTOH, as we see above, still use them long term, often as a convenience. I still use them - my own blend, as with most things - as an exercise recovery drink after the gym. My wife uses some of the powder in the regular smoothie that she makes (20 years post op) in which she also includes some of the added supplements that she still needs (for her DS,) So, if you can get away without them and still get the requisite protein, and object to drinking them, then great - you can do away with them. If you like them and they still provide some benefit or convenience, there's little reason not to continue using them.

I’m certainly not trying to be argumentative either. The reason that I went out of my way to state that it was from AI to begin with is so that the OP would be aware of that fact and take it as they may. Then I added that I was able to see the original articles and they could too if they did the research themselves and I suggested that they ask their doctor if it applies to them specifically. Also if you’re speaking specifically about the part that was talking about their rule of thumb for number of calories per pound, that was not from AI at all. That was from hss.edu and I referenced that above so that one can find and read the article for themselves and determine if it is applicable. It was all intended as food for thought and something to look into. Not medical advice as I am not a doctor Personally, if I have a question I gather data from a lot of sources to include chats and AI summaries as well as medical journal articles or friends and then I ask a professional to decipher the medical jargon, tell me what out of the chat and less reputable sites or word of mouth is true and what applies to my specific situation. In my opinion though, what it boils down to is that our metabolism while recovering from surgery or something else is going to be different than the same person when they were feeling fine just trying to lose weight and we should at least be aware of that and ask the right people the right questions if we care about weight, muscle loss, recovery time etc. I can only ever speak accurately about my personal opinion or experience and that experience is that the oncology dietitians’ advice worked for me and it was basically if you’re craving a cookie then no, don’t have it but if you’re craving fruit or vegetables or something otherwise nutritious then your body probably needs them and you should listen to that when your recovering from something. Basically don’t just be counting calories and starving yourself during recovery, nourish your healing body. Of course my situation is different so that’s why you should always consult with your doctor.

Not trying to be argumentative here, but this seems like a bit of a strange comment considering that Google literally states that "AI Overviews use generative AI, which is a type of artificial intelligence that learns patterns and structures from the data it is trained on and uses that to create something new." Personally, I think it's important to treat anything AI Overview produces with a significant bit of skepticism. I don't doubt that this particular response was generated primarily from other sources since that's literally how AI works. That said, there's an old adage in computer science that goes "Garbage in, garbage out". This is just as true today with AI as it was in the dawn of the computer age. I absolutely agree, but there are 2 things we need to take into consideration. The first is to what extent we burn additional calories. There is data in the scientific literature showing that RMR (not total calories burned), increases anywhere from 15% to 50% during the acute recovery phase. Whether it's near 15% or 50% depends a lot on what one is recovering from. I'm sure you'd agree that having a grade 1 muscle strain is not nearly as taxing on the body as chemotherapy or, say recovering from extensive burns. Add in the fact that most people have no clue what their RMR is and it can be very difficult to estimate the exact amount of additional calories burned. (Plus, the farther along the recovery process you are, the lower the increase in RMR.) The second confounding factor here is whether one actually needs to eat back those calories or not. Just because one is burning more calories does not mean one also has to eat all those calories back. This unfortunately is not clear at all in the scientific literature so we're sort of on our own here. My personal belief is that if your calorie needs have gone up a lot because you're recovering from a significant injury/illness AND you are at or below maintenance, then it's probably more important to eat more because you have less stored fat to fall back on. On the other hand, If you still have excess fat stores and/or are recovering from a more minor injury/illness, then you probably don't need to consume as many calories as you might otherwise. I also tend to believe that eating good quality foods is probably more important here than just eating more calories. 1000 extra calories of junk food is not going to help nearly as much as 250 calories of whole foods. The problem is, most of us are just not going to be able to accurately calculate any of this. This is why I'm recommending caution and only jumping up a lot in calories if major fatigue is an issue.

Well, it wasn’t exactly an AI generated recommendation. It was an AI generated summary of all the articles that applied to the question I asked Google. So basically One of the articles them gave that recommendation is below and you can read the full article of course and determine whether it’s a reputable source and applies to you. I agree with not going by a cookie cutter approach regardless of where it came from. Especially the Internet, but it logically does make sense to me so it would definitely be worth talking to your doctor about and asking for a specific plan for you. I know for me, my body is fighting cancer and processing chemo right now which both increase metabolism. Currently I’m logging like 1000-1500 cal more a day and still losing (albeit a little slower to appease my doctors). It changes your metabolism when your body is fighting something and it does burn more calories during times like this. How many that would be something your surgeon may be able to help you with a refer you to someone who can. I am very fortunate that I am at a big fancy breast center and they have an oncology dietitian that is helping me throughout all of my different treatments that I have in store for me over the next year to keep me on track for both that and my bariatric journey. i think the most important part would be to just be mindful of the fact that healing does require adequate nutrition and not to be at too much of a calorie deficit because yes, we will heal like we did from our bariatric surgery but that doesn’t necessarily mean it was the ideal circumstance or that we we’re healing as fast as we could have. I know you are itching to get out and back to your activity asap as I would be and good nutrition is very important for faster healing. I’m not saying that means you need to eat as much as you were eating when you were working out like crazy, but if it was me, I would focus primarily on fueling my body to get better faster, without gaining of course, and really focus on the weight loss once I was back on track (it won’t be that long). I mean if you can lose a bit great but if your body is screaming out for nutritious food it’s probable that there is a reason. The nutritionist that I am working with would not give me a specific calorie amount instead she told me to still try to avoid cookies and chips, but to eat when my body was craving nutritious food and she checks in with me every week to see how I am doing and make tweaks Does your surgeon have a nurse practitioner that you could talk to if you give them a call? Or was your dietician from pre surgery very helpful (mine was worthless 😂). Maybe you would get a more in-depth response from them than your surgeon who’s always super busy.

@AmberFL I must have missed that you are recovering from surgery. While I probably wouldn't recommend a significant fat loss diet while healing, I'd also be a bit cautious about using Google AI recommendations. The idea that you need 15-20 calories per pound of current body weight to heal just doesn't pass the smell test. If this were true, none of us would have properly healed from our bariatric surgery. Keep in mind that 15-20 pounds for you right now would be roughly 2500 to 3400 calories. At your starting weight, that would have been about 4500 to almost 6000 calories a day! Looking through the scientific literature, I couldn't find a single reference that this level of calories was needed to promote healing after surgery. There were some references to additional calories being helpful in the event of significant wounds, thus your calorie needs may be somewhat higher for more involved surgeries vs simple ones. I apologise, but I have no idea what "PS surgery" is, so that doesn't really help narrow things down. I think my recommendation would be to base this more on feel. If you are feeling really rundown, that's probably a good indication you may need to up your calories. You're always going to feel somewhat tired after any major surgery, so I'm talking about feeling excessively tired. If you do feel the need to add more, my recommendations above regarding macros still stand. We do know that wound healing requires adequate protein (thus 1.6g/kg is a good minimum target). We also want to make sure you're getting adequate essential fats, so shooting for a minimum of 50g is still good advice. If you are more like 70 to 80g, especially when not on a fat loss diet, that's just fine. I wouldn't necessarily recommend going much higher that that on fats because if you do, if will mean you would likely be subtracting calories from carbs. Good whole food sources of carbs like whole grains, vegetables and fruit have tons of nutritive value that you really shouldn't be skipping right now. In short, protein first, essential fats next, and carbs for the rest of the diet.

Okay so I was curious to know exactly how much more our bodies burn while we are healing so I asked Google and this is copied from AI response. Basically if we need more calories to maintain as your healing you really may be good by just cutting back a tad on the extra Carbs since your carbs were much higher due to a very high level of activity, which you’re not sustaining but honestly if I was you I would Just wait until your through this to worry about losing you could take even longer to get back on track if you try to lose now “Yes, your body burns more calories during the healing process after surgery. This is because your body's metabolism increases to help heal the incisions, fight pain, and prevent infection. Explanation Hyper-metabolic state After surgery, your body enters a hyper-metabolic state, which means your metabolism increases. This causes your body to break down muscle protein, fat tissue, and neurotransmitters to provide energy for healing. Calorie needs During the healing process, you should consume more calories than normal. A general rule of thumb is to consume 15–20 calories per pound of body weight. Protein needs In addition to calories, you also need more protein during the healing process. Protein is a key building block of the body and is necessary for tissue growth and repair. Hydration Drinking plenty of fluids, mostly water, helps deliver nutrients to the wound site. What to eat Eat a balanced diet with a wide variety of foods Eat nutrient-rich foods like fruits, vegetables, lean fish and chicken, grains, beans, and nuts Take a multi-vitamin/mineral supplement if you don't get enough nutrients” This is from HSS.com “How many calories should I be consuming since I will be inactive? Now is NOT the time for weight loss! When people are immobilized, they worry about gaining weight. However, you should NOT decrease your calorie intake because you will be inactive. In fact, your calorie needs are now greater than usual because your body requires energy from nutritious foods to fuel the healing process. You will need to consume about 15-20 calories per pound (using your current body weight). If your overall energy and protein needs are not met, body tissues such as muscles and ligaments will begin to break down. This will compromise healing and may prolong your recovery period”