So I had my 3 month post op visit with the nutritionist as well as a PA from my surgeon's office.

First the nutrition was telling me that when I hit the 6 month mark that I can only eat 3 meals and NO Snacks. I said "really"? I asked her to explain to me what the advantage is of eating 3 large meals vs 6 smaller ones during the day. I shared that all of the diet plans that I had every been on stressed the importance of eating smaller meals so that you don't get ravished in between. I told her I had NO intention of eating 3 big meals a day but would plan on sticking to my 6 "meals" of 200 calories each. She just looked at me and said "well, that would work too". Well then why are you stressing "absolutely NO snacks". Sheesh! Everything I have ever read AND other nutritionists that I have spoken to have all said that the more frequent smaller meals are healthier. Any feedback???

Second, the PA told me to wean off of my PPI. It was kind of weird because I had stopped taking them a month or so ago and when I went for my last appointment, the NP was appalled and told me to get back on them, so I did. Now the PA is saying I need to get off of them but to wean off slowly because if you stop cold turkey your body will actually produce MORE acid. So I am going to wean off but was curious as to whether you all are still on PPIs or no?

Everything else going well. They said that they expect people to be at 50% of their weight loss at 1 year and I am almost at 50% after 3 1/2 months so I guess I am doing well. Weight loss has slowed to about 1/2 pound per week or so but I'll take it. And I know if I could ever get my butt to the gym more often that would really help.

Bottom line is that I have lost 52 lbs in 3 1/2 months and am thrilled!

Pamela I am also puzzled at the dietary advice, three meals a day might be fine as long as you are not eating three too big of a meal I suppose, I feel safer having a little protein snack here and there, a piece of papaya something so that at meal time I am not trying to get all my protein for the day in one shot. I am only 4 weeks out but the literature that has recently come out always points to frequent small meals. You have done amazing in this journey so take what you can use from the NUT and use what works for you, obviously you have done a lot right. Good Luck

I too have heard that the metabolism stays revved up if you have 6 smaller meals. Your nuritionists idea of snacking might mean eating your meals +extras, so when you explained to her you meant breaking the meals down into smaller meals, that probably doesn't constitute as snacking.

I think snacking for me is the idea of just having things in between meals that aren't thought of as meals...a bit like grazing...like having a bite of cheese here and a bit of toast there.

But the fact that you are actually recognizing each part as a small meal, that's not the same as snacking in my book. Hope that helps!

She actually showed me a meal plan that had 3 distinct meals laid out. There was a ton of food in each meal - all of the food that I actualy spread out over the day. She said that they want to get you used to eating only 3 times a day and not eathing anything between. Sorry, doesn't fit with what I know works well for me OR the advise of every other diet out there.

My nut said three meals, two snacks. I'm really happy about this. Perhaps its a mindset, some folks just want to participate in the classic American three sit down meals a day routine. Even if I'm not hungry, having planned snacks really help me keep on track instead of grabbing junk because I find myself starving.

My Nut also says three meals and no snacks and that seams to work for me. I think that all nuts and drs have different educations and there for differing views on subjects. you just need to listen to their advice and then listen to your body and come up with a plan that works for you that combines both. As for the PPI my Surgen has me on mine for a full year, all though I don't know if I ever want to stop as the last time I ran out I was "hungery" all the time and when I take them I am never hungery. Sounds like you are doing awsome so just keep up the good work.

I stopped my PPI at 3 months too -- no real problem with acid (a couple of days here and there and then I took the PPI) but I haven't had acid in weeks now. So I'm pretty happy with that.

I'm eating 3 meal a day too -- but I do have a snack occasionally.

Hi Pam,

Yea me too with the three meals and no Snacks ... I think I was told this to stop the habit of eating inbetween meals and therefore adress any grazing issues... I tend to stick to this 85-90% of the time. If I do have a snack it has been Protein based ie cheese, ham, etc but I am going to start to include some fruit and veggies now too!

Your weight loss to date is amazing by the way.... congrats! =]

My doc also stresses the 3 meal, no grazing rule! Of course, I'm still on liquids so I haven't had to deal with this yet. The reasoning behind their logic is that most of us aren't "normal" eaters. If I could have followed the literature and lost weight, I'd never have had 85% of my stomach removed in order to lose weight! But, at least for me, I ate emotionally, I grazed, and I just loved food! I'm willing to follow my surgeons advice and hopefully gain a healthier relationship with food in the process!

I think that the nutritionist is forming a plan for someone with a normal sized tummy. I agree with an earlier poster that you should consider what they tell you, AND listen to your body, then formulate your own plan. Your body will tell you what it needs. 3 big meals a day would definately not work for me. I eat when I am hungry and that could be anywhere from 2-6 times a day. Just make sure that when you eat, what you are eating is good.

Did they give you a reason that they want you off of the PPI? I am just wondering because as a nurse I know that some people are on them for years. If it works, then why would you change it? I take one in the evening, and if I don't I tend to reflux pretty badly at night.

You are doing great!!!!! Listen to your body, it will tell you what it needs. Hopefully by now you have tackled a few of the behavior issues that trigger "grazing" or mindless eating. I kind of think that eating just because it is mealtime also incorporates behaviors of eating when you aren't really hungry. I may be way off base, but it's just my opinion. When I went to my doctor at about 3-4 months, he did lab work and we both agreed that as long as I wasn't deficient in any areas and I was losing at a reasonable rate, then what I was doing was working.

Kathy

Isn't grazing when you tend to just pick all day compared to planning your meals and snacks? Also, with the sleeve how would you get enough food in eating only 3 meals a day?

Pamela you are doing really great, you should be really proud of yourself. I'm ten weeks out and lost only 30 pounds eating no more than 800 calories a day, I haven't lost a pound in 2 weeks. Good luck!

My doctor also told me I would be on three meals a day and no snacks. He told me the 6 small meals a day is for body builders not people that are overweight and needing to lose pounds...LOL sounds logical to me.

I FIRMLY BELIEVE MOST NUTS JUST DONT GET THE SLEEVE!!

Pam,

Congrats on your weight loss!! I tried to wean off the PPI but felt like I was hungry all the time (wanting to graze), when i went back on the PPI, that feeling left, my surgeon told me I could have up to 2 per day! My feeling on this is do what is working for you!

How it was explained to me is...

If you eat six meals a day, they are afraid that you won't have the time to get all your fluids in. They don't want you to drink while eating because it will help mush up the food and possibly allow you to eat more...

Funny you should mention this... I had my "one month" checkup (although it is really six weeks, due to the holidays) this week and came away very disappointed with BOTH my NUT and my PA.

First of all, the NUT also stressed THREE MEALS A DAY, ONE SNACK and nothing else.

She gave me a printout of a "3 meal a day" paper with sample diets.... here are two samples from that list. See what you think... in my opinion, these are Snacks, not meals:

LUNCH: 2 oz. Tuna w/ 1 TBSp mayo& 4 whole grain crackers, + half a small bannana.

DINNER: 1/2-OZ Poached Fish + 1/2-Cup canned peas.

SNACK: 4 whole grain crackers & 1/4 Cup Egg salad.

What's the difference? To me, it looks like the same amount of food for a snack, as for a lunch or dinner. So although she is stressing THREE MEALS A DAY only, she is really telling me to eat four teeny meals a day. AT this point, I couldn't eat all of the lunch... I would save the 1/2 banna and maybe a cracker for a fifth teeny meal.

I really think that what the NUTS are afraid of is that we are going to start grazing... eating bites of anything we want constantly.. and they just want to reinforce that we need to sit down to regular "eating times" and not eat on the run.

My NUT also put a note on my meal plan that says... "If you are unable to eat a meal, try to at least have a 4-8 OZ skim milk (or Lactaid) with 1/2 scoop Protein power." What's that if it's not a snack?

Is anybody counting calories? She told me that I used to count calories, but now I'll count protein. I can eat so little that I could never consume a lot of calories, even if I ate nothing but potato chips and dip... although I HAVE noticed that processed, prepackaged foods go down a lot faster and easier than "real" foods, such as veggies and meats.

Anyway, back to my rant... worse than the NUT meeting was how RUDE and MEAN the P.A. was to me. She rally confused me.. she says "what kind of exercise have you been doing?" and then proceeded to yell at me for not "walking at racewalk pace an hour a day until you sweat..." but after surgery, I was told NO exercise for six weeks except take a walk every day & try to get your heart rate up. Which is it???

She also told me that I should take no pain killer but Tylenol for a WHOLE YEAR, nothing else, or I might irritate my staple line and cause an ulcer. First time I had heard that... AND she took away my PPI... she said "if you have developed GERD we have to fiind out why, and not just treat the symptoms."

She was SO MEAN TO ME that I am not going back there. I heard nothing of value from the NUT, and I didn't go through all this and pay all this money to be yelled at by a mean doctor.

I'm on my own.... nutrition section of the library, here I come!

Cinderella

This is all very interesting. I know there are times... LOTS of times that if I listen to what my body wants, I eat too much, and of the wrong things. Now maybe this is not my body talking, its my head, but really they are connected at the neck, and have something to do with each other. I have spent quite a bit of time analyzing the cause and effect of what I eat - to how I feel... and I find that when I eat some kinds of food I may generally love how they taste, and like putting them in my mouth, and like the immediate feeling it produces... through my shoulders and chest of all places, but what is missing is satisfaction. I'm not talking about feeling full. There is something I am looking for that I don't usually get from food...satisfaction. Like, Im finished now. I feel fine, I got the energy from the food now... or something like that. Perhaps this is partly what people call emotional eating. I think emotions may be part of the picture sometimes for me, but not always. The satisfaction I crave feels more physical.

When I really look close at the/my overeating experience, this is missing almost all the time. I realize I don't really like the taste of the food that much... the taste is not enough for me to be satisfied. Its like I'm not getting the basic nutrition I crave or something. Now I think this is where the addiction label comes into the picture. That craving for satisfaction. I just look for it in the food over and over again. Some types of food really heighten this experience...you all know what they are.... refined carbs... sugar, the "whites" High Fructose.... Its not the fats, its not the Protein, its not even the whole grains and carbby vegs in moderation. The only time I get satisfied, is when I cut them out. And I need to cut them out for at least 3 weeks before I feel the satisfaction creep in. When I do this, then the size of the meal goes down, and the pounds start to slide off, and I can start to trust what my body/head asks for. However I make myself eat protein Snacks even then, because if I let myself get too hungry, the chance of the old habits to reach for the easy donut are a little easier, and I just don't want to go there and start the cycle again.

Just sharing some of my self exploration.... So anyway, thats why I am happy about my nut recommending three meals and two snacks... it is easier for me to keep the satisfaction in place this way....IF i eat the right foods. Protein first!

I am going to put this in my blog too... sorry for the repeat guys...love ya! Thanks for all the opportunities for self reflection and insight to to your experiences....