Ok so I will be 4 weeks post op this friday and because I was a cash pay patient, i wasnt really required to go through many classes before the surgery. It was kinda like, ok u made up your mind that you want the surgery, get surgical clearance from your doctor, take this physc exam, and then go to the 1 hr group nutrition class (which didnt really cover much) and then I had surgery. Im not complaining, cuz I know theres alot of people that have to jump through hoops just to get the insurance company to pay for the surgery, but my point is, not having to do so many things pre op, coupled with a surgeon with a seemingly more relaxed aproach than alot of other surgeons ( at my 10 day check up he cleared me to pretty much eat watever I wanted but to avoid startches and to take it slow) i wasnt really sure exactly what I needed to do/ eat post op reading on here it seems like post op people have very strict guidlines so that made me decide I needed to get a nutritionist. Well I went to my nuts appointment today and she went over what im eating (mainly protien and water intake) and pretty much said she had nothing to tell me, im doing it all right. She did say that she would like to see me incorporate more startches in my diet (bread, potatoes ect) and it just kinda confused me, I mean whos right? My surgeon or my Nut startches or no starches? Im wondering if i even should be going back to this nut she didnt really help me, if my surgeon gave me any instructions it was to be avoiding startches. Is there any of you that didnt have a nut and didnt feel you needed one? Or vice versa was there any of you that had/have a nut and found them important in your journy.

Is your nutritionist experienced with bariatric surgery patients? I ask because it sounds like she is trying to steer you toward a more "balanced" diet even though she said you were doing it right. Are you losing too fast?

I'm following my surgeon's directions when it comes to diet. If I ever consult a nutritionist it will be during maintenance phase.

I'm not a fan of most nutritionists. Sorry, but I'm just not. I've had my fair share of fun little classes with them, and they seem to contradict everything the surgeon says, and I typically confront them on it.

I think the avoiding starches/carbs is a great approach. Healthy carbs from fruits, veggies etc not so bad, but to talk about eating bread, that's the biggest no no that's pretty much across the board for all WLS types, not just the sleeve. It takes up valuable space that could be filled with nutrient dense, and Protein dense foods.

I haven't been to see the nut in over a year now because it was just a conflict every time. I like guidelines, I really do. But, I also believe that guidelines are kind of a "one size fit MOST" not a "one size fit all" type thing. What worked for me very well might not work for the next 10 people, but it worked and continues to work for me.

Ditto what the others have said. I'm someone who has to steer clear of refined carbs and really starchy food, esp. potatoes -- nothing white. Luckily that is the post-op eating plan my sugeon has us on, although I could have whole grain bread now if I wanted to. I'm six months out but still with a lot of restriction. Our rule, which seems to be similar to that of others on the board, is protein first, then veggies and some fruit, then whole grains if room. I too would go with my doctor's plan for now if I were you

I am also a self-pay patient, but maybe things here in the UK are different. My surgeon and nutritionist work together as a team, as it should be. I am allowed healthy carbs, have been since I started eating, obviously not in unlimited amounts because 1-I won't have room for protein 2-I won't lose weight. I work with my sleeve, when I'm on a stall I try and cut down my carbs as much as possible, and then I go back to adding them to my diet. It works for me, but as Tiffy says what works for me might not work for the next person. I just find it strange that having self paid your surgeon doesn't work along side a Nutritionist.

I just find it strange that having self paid your surgeon doesn't work along side a Nutritionist.

I thought the same thing! I would definitely try a new NUT or ask your surgeon if he knows of any.

My surgeon gave me a huge 3 ring binder filled with pages of notes and specific guidelines, etc. He also has 3 in-house NUTs whom I saw for 6 months prior to surgery AND they run his support groups.

I think there is some online documentation about someone's guidelines in PDF format, maybe try OH and search for it, or even search here, as it could possibly help just give you some clear direction.

I personally have to limit my carbs or I don't lose. I'm carb sensitive, but do okay with small amounts of healthy carbs. The junky white carbs/sugar just make me want more.

Is your nutritionist experienced with bariatric surgery patients? I ask because it sounds like she is trying to steer you toward a more "balanced" diet even though she said you were doing it right. Are you losing too fast?

I'm following my surgeon's directions when it comes to diet. If I ever consult a nutritionist it will be during maintenance phase.

Im not really sure if shes experienced with bariatric surgery. It took me alot of calling around and searching to find someone that seemed to know what they were talking about when it came to WLS and when I called her to make an appointment with her after I had already scheduled the appointment she said, "Oh wait wednesday.....im guna be at the other office wednesday.... well I have another dietician that works for me and she will be at that office will that be ok?" and me being stupid said sure. So The dietician I saw who was really nice maybe just dosnt have the experience that I had hoped for. As for losing too fast, definately not. Tomorrow is my 4 week post op mark and I might be at around a 15lb loss.

There's a good website called Insistute for advanced bariatric surgery that has a diet guide in PDF format, I would copy and paste but my computer isn't working properly

I was fortunate enough to have an excellent surgeon that has a nutritionist on staff and she is a WLS patient! So she has an excellent point of view. Everything about the program is coordinated and they give you handouts with all the dietary instructions about what to eat for each week post op. Protein first is their motto.

My doctor works with the nutritionist at the hospital. We had to go through a 3 hour class prior to surgery-this is the surgeon's requirement along with going to a support group. I had to get signed certificates to turn in before they would turn into insurance. Our bairiatric nurse is also a WLS patient. She stopped in to see me prior to surgery and afterwards and called me several days later to make sure I was doing okay. Our classes are separate from lab bands patients to gastric and sleeve patients and ever our support groups are separate. You may want to see if you a Bariatric Center of Excellance which normally has support groups and may be able to give you names of nutritionist that are familiar with weight loss surgery. I did find several websites that had their diet plans posted. Every place differs on their guidelines but if your surgeon is saying one thing and the nut is not part of his staff or support-I would follow the surgeon over the nut. Keep a food diary and see what works for you. On the week that you ate starches how was the weight loss to the week where you keep it low. We are to try to have no more than 15 grams of carb with 5 or less gram of fat per serving. Good Luck.

I have a wonderful surgeon, and a fabulous nutritionist, and as several others have said, they work together so that is the best option. But I have to tell you, I was an insurance approved person, and I didn't get much more guidance than you did. After jumping through all the hoops, I ahd a one-hour meeting with nutritionist, and she gave me their program "booklet," which I read like it was the Bible.... and stuck to. But most of my information, I have gotten either here at this site, or by researching and searching the Internet.

One thing I do know is "eat your Protein first..." because we so need our protein. BUT, we also need some fruts and veggies, because.. Protein is a building block for sure, but your body can't "unlock" it and use it without Folic Acid, and other acids whcih are only found in fruits and veggies. So they are literally KEY to your health and strength becuase they enable your body to USE the protein that you eat.

I picked up two wonderful, inexpensvie little books that have helped me a LOT. The first is a little book called WHAT TO EAT, published by Cooking Light, and the second is a PROTEIN COUNTER guide that explains a lot about protein and how your body uses it in the front.

When avoiding Carbs, avoid the processed, startchy kind that have no nutritional value.... for example, Doritos or Scalloped Potatoes or Cookies.

But eat your veggies and fruits as much as possible! I know it's hard we can eat so little.... check out those two books and they'll help you more than any nutritionist!

Good luck, Cinderella