Hello,

Tomorrow is my 6th month appointment with my nutritionist for my supervised diet. This is an insurance requirement for my UHC insurance. I have been meeting with my nutritionist once per month since July. My supervised diet consists of no carbs. Each meal should consist of 3 ounces of Protein one cup of fruit and one cup of vegetables. I have been following the diet to the letter and I have not lost during these 6 months. Each month I go in and she tells me something different to do. I thought finally I was down but then nothing changed in my diet/lifestyle and I gained it all back. I'm so frustrated. Obviously diets don't work for me and that's why I am wanting to do the surgery. I'm 5'8 and 317lbs. My highest was 323 and that was 3 months ago. Like I stated my weight has been up and down during these last 6 months and I just don't know what to do. I don't think its an insurance requirement to lose weight during the 6 months, but just to have a supervised diet. My nutritionist told me at my last appointment that she would like to see me down 10-15 pounds during the 6 months. I have a feeling tomorrow she will tell me that she wants to monitor me for one additional month. I don't see what the difference will be. I know your questions will be, well how about excercise. Right now its non exisitent. We are on mandatory overtime at work and I'm putting in over 65 hours a week. I sit all day! I take the stairs and walk as much as I can. I can't help that I don't have time to work out. I'm also a full time student so I have no free time! I have eliminated all caffine per the nutritionist and with all this overtime I am dying! I can't tell you how much I would like a cup of coffee!

Have any one you had trouble with the low carb diet? Like I said, I was finally down last week but I think I found the answer to why i gained it back. I lost 7 pounds during the week of my period. I was not taking my birth control pill. As of Sunday when I started taking my pill again, I gained 4 pounds back. ...... And I'm not getting off my birth control....

This supervised diet is also my pre-op diet. My surgeons don't put the patients on a liquid only diet. The low carb diet is to shrink the liver. I can't tell you how small my liver must be right now after doing 6 months of this but it's crazy that I haven't lost any weight!

Has anybody else out there had trouble losing on the low carb diet?!?!?!?

Will see what my nutritionist says tomorrow. I hope she still sends my info to insurance for approval without making me wait one more month. I'm so worried about other health factors now such as high cholesterol ect. I never used to eat this much meat and fat.

---------Kara

How frustrating for you. I had to do a 2 week pre-op liquid diet and was able to loose 10 lbs prior to surgery. I basically drank 3-4 Myoplex Light - Choc Fudge shakes - almost every day. (They are 11 oz box drink) Plus 64 oz of liquid each day. I found that if I drank 1/2 of a shake every 2-3 hours I would not get hungry. I just had my surgery on Monday and am now trying to get that much in - I am not having ANY hunger pangs but am still sore from my surgery. Protein is so important for healing and maintaining muscle mass. I don't know if you have went to this extreme but thought I would throw it out there for you to talk to your NUT about. Hang in There!

That sounds incredibly frustrating. I'm really sorry to hear it! The only thing I can suggest is that you might cut out the fruit. Fruit is pretty high in sugar, so it might bring your carbs down better. Also, I find that if I don't exercise, I don't lose weight. Exercise is pretty key for me. I know it's hard when you work a ton of OT, though.... I've read studies where they say you get the benefits of exercise even if you break it up during the day. So, maybe a 15 minute walk before work, a 15 minute walk at lunch, and another 15 minute walk after work?

I am sort of in the same boat as you. I've been doing the nutritionist supervised diet for over 6 months, and I actually gained weight. I will admit that I was not following it a rigorously as I should and I gave myself the excuse that it was okay because I had also given up smoking at the same time. However, I met with the surgeon and he told me that if I didn't have 'significant' improvement, then I would have to postpone the surgery. I am now religiously following the low-carb, high protein diet. One thing that I think has helped me to start finally losing weight is that I am measuring all my food to make sure the portions really are correct and I am also avoiding sodium as much as possible. Like you, I work 65 hours a week, so getting to the gym is difficult. I am forcing myself to get there at least 3 times a week even if it means going after I have worked a 12 hour day... which is horrible. But I am finally seeing some results and hopefully that will be enough for the surgeon. My best advice is to keep detailed documentation of everything you eat, drink, and any exercise you do. Even without weight loss results, showing that you are putting in the extra effort should help a lot. Best of luck and fingers crossed that you will be approved.

Thanks for the replies. As far as excersise goes, you have know idea how much I want to work out... I just can't. I'm both mentally and physically exausted at the end of every day. I calculated it out, I have 3 hours of free time if you subtract the hours I'm at work, my drive time, and time in the shower. I don't know where those 3 hours go b/c when I get home I swear I eat dinner and go to bed in only an hour. I don't know where the other two go. I'm also a full time student so my breaks and lunch I study. I sit at a desk all day so I walk around and stand up and get up as much as I can during the day. I take the stairs instead of the elevator. I just don't know what else to do. I even work on Saturdays. Sundays are my only free days and by the time Sunday comes around I just sit and do nothing becuase I'm so exausted. I have a treadmill and elipitical and weight sets at home, so its not like it would be hard to work out.... I just don't have the energy!

As far as my carb count and fruits.... I have pretty much eliminated them. I may include fruit in one meal during the day and it usually consists of a yogurt w/ less then 16 grams of carsb. (light and fit). I consume only about 30-40 carbs a day. The carbs come from my vegetables, eggs, and sometimes I have a cup of milk. I measure and weigh everything. I use an application on my cell phone that allows me to scan the barcodes of food and it puts in all the dietary information for me so I am keeping very good track.

I have talked to my nutritionist about the fact that I was gaining weight in the beginning of my 6 months and she told me sometimes it takes a couple of months for peoples bodies to get used to the diet. 3 months later I had finally lost the weight I gained in the beginning of the diet but was not losing. This month like I said, I thought I finally had lost some weight but then my cycle ended and I started my birth control again and have gained 4 pounds back in 3 days!

I weigh myself every day! I know I shouldn't do it! I can't help it! As you can see its a good thing I do so I can monitor my day to day differences.

I have no clue what she is going to reccommend for me tomorrow to lose weight before surgery. I would love to add more excercise to my life but I just simply can't unless this mandatory overtime gets cut. (I work for an insurance company, not UHC, and its our busiest time of the year! Open Enrollment!)

The only time in my life that I can recall losing weight on some form of a diet was when I was on Phentermine. What does that pill do to your body that you can lose weight!?!? Every other diet I have tried I have not lost anything more then 10 pounds..... I just don't get it.....

Obviously!!!!! This is why I need the surgery!!!!!

Anyway.... Will see tomorrow morning what she says!

Typing from my phone so I apologize. Just got done at my Nutritionist appointment. I am down from last month, but she would still like to see me again next month. Insurance requirement is met, but its up to the center of excellence if they will send it off to UHC. My surgery will be approved at 100% if I have the surgery at one of UHC's centers of excellence, but the center has there own requirements as well. They want to see a drop in my weight during the 6 months. I can only hope they send my supervised diet info along with my psych evaluation to the insurance for approval and then give me one month to continue to try and drop the weight. My Nutritionist said my diet looks good, I just need to cut out the sides, mayo, ect. I also need to try and get some exercise in.... I'm going to try this month even if its before or after a 12 hour work day..... here's to hoping they send it for approval and I lose weight this month to make the center happy!

Ugg..... frustrated......

Kara

Fingers are crossed for you. Keep us updated with what happens.

I dont know a huge amount about low carb, but i was under the impression that you lose weight quickly doing low carb as your body goes into ketosis, where there are no glycogen stores for it to use so it burns fat instead. in order to get into ketosis in the first place you have to completely deplete your glycogen stores, for me to do that i have to eat less than 20g of Protein a day for a week or so, only when ive been in ketosis for a few weeks can i up to 50g and still lose....

edit: sorry, i meant 20g carbs obv

I am supposed to do low carb high protein. How can I get less then 20 grams of protein while staying low on carbs without starving myself? Did you mean less then 20 grams of carbs?

Kara

I can totally relate to your struggle. I could not lose any weight pre-op no matter what I did. I would follow a strict low carb diet, exercise like crazy at the gym (for me anyway, I would do at least 30 minutes treadmill and 40 minutes swim at least 3 sometimes more times a week). It was so frustrating so don't lose heart. My insurance had a supposed 10% weight loss requirement and a 6 month class before getting anywhere near approval for surgery. I started the program last January at 256 pounds and the day I went into surgery on Dec 29, I weight 255.1 pounds. I didn't even lose a whole pound after a year of struggle. But they gave me the surgery anyway because I did not gain any weight. So at least, hopfefully, if you can maintain whatever you were when you started with your doctors, you should be able to get the surgery. They waived the 10% requirement for me and made me jump through about 2 extra hoops but I still got my surgery. Now, I'm 2 weeks post op and down 13 pounds. That is the most I've lost at one time in years. Hang in there. You are doing your best and that is all you can do. Smillzee

I dont know a huge amount about low carb, but i was under the impression that you lose weight quickly doing low carb as your body goes into ketosis, where there are no glycogen stores for it to use so it burns fat instead. in order to get into ketosis in the first place you have to completely deplete your glycogen stores, for me to do that i have to eat less than 20g of protein a day for a week or so, only when ive been in ketosis for a few weeks can i up to 50g and still lose....

I think she meant 20g carbs.

I guess my thought is why do you work 65 hours a week? That is a lot. How could you get the time off for this surgery, because you will need time to rest. I wonder if it is your stress level that is throwing all of this off, bc you sound very dedicated to the process.

Life is not work. But we all do this at times of our lives, just don't work yourself this hard your whole life, right?

I hope you get your surgery! I don't quite understand the point of having to lose weight during the 6 mos though. How weird. I mean, if you could lose weight without the surgery and keep it off you would. They know the odds on that, so wow, kinda weird to me. I didn't have insurance for this, and my center of excellence wisked me through. How strange.

I guess my thought is why do you work 65 hours a week? That is a lot. How could you get the time off for this surgery, because you will need time to rest. I wonder if it is your stress level that is throwing all of this off, bc you sound very dedicated to the process.

Life is not work. But we all do this at times of our lives, just don't work yourself this hard your whole life, right?

I hope you get your surgery! I don't quite understand the point of having to lose weight during the 6 mos though. How weird. I mean, if you could lose weight without the surgery and keep it off you would. They know the odds on that, so wow, kinda weird to me. I didn't have insurance for this, and my center of excellence wisked me through. How strange.

I work for an insurance company and right now it is our busy season. "open enrollment" All areas of the company are on mandatory overtime. My husband has been unemployed for over 2 years and is also a full time student. He lost is unemployment 4 months ago so I have been working additional overtime over the mandatory to compensate for the money lost by unemployment. My husbands school schedule does not allow him to find a part time job so I am the only one bringing home income. As far as getting off for the surgery I have excellent benefits here. I will use 5 days of sick time and then short term disability for the remainder when taking time off for the surgery. That won't be a problem. I am going to have to start cutting down the additional overtime I'm doing anyway because I joined a Bariatric Support Group last night that was recommended (not required) by the psycharisist. I will be going to that every Thursday night for the next 7 weeks.

I think you are right about the stress.... I have so much going on in my life and stress is a huge factor when trying to lose weight. Sooner or later I am going to have to cope with the fact that I need to cut down the overtime to spend more time taking care of myself.... Starting Monday... I've decided to plan out every day w/ a set schedule....

Monday, Tuesday, Wednesday, Friday

Alarm: 3:00 AM

Wake up: 3:15 AM

Get ready for work out: 3:15-3:30 AM

Work out: 3:30-4:30 AM

Get ready for work: 4:30-5:30

Drive to work: 5:30-6:00

Work: 6:00AM-5:30 PM (3 hours of overtime)

Drive home: 5:30-6:00 PM

Cook Dinner/Eat dinner: 6:00-7:00

Relax/ Do homework/ House duties: 7:00-9:00 PM

GO TO BED: 9:00 PM

Sleep: 9:00 PM-3:00 AM

********Start all over again********

Thursdays

Alarm: 3:00 AM

Wake up: 3:15 AM

Get ready for work out: 3:15-3:30 AM

Work out: 3:30-4:30 AM

Get ready for work: 4:30-5:30

Drive to work: 5:30-6:00

Work: 6:00AM-5:30 PM (3 hours of overtime)

Drive to support group meeting: 5:30-6:00 PM

Support Group: 6:00-8:00 PM

Drive Home: 8:00-8:30 PM

Relax: 8:30-9:00 PM

GO TO BED: 9:00 PM

Sleep: 9:00 PM-3:00 AM

Saturdays

Work 8:00-2:00

Relax/chores/etc rest of day

Sundays

Relax/chores/etc All day

I know to some of you this may seem crazy.... but I still need to work the overtime... and I still need to get the excercise in.... I think this will be the only way.....

My journey will begin on Monday morning.... I figure I'm already waking up at 4:00 to work overtime... I might as well wake up an extra hour early to work out....