Over the past few weeks, I have read numerous accounts on these forums of VSG patients who have lost large sums of weight over the first month or so. Obviously, the more weight you have to lose, the faster you lose initially. My specific question is—to those who have investigated this for themselves—how do you explain the weight loss when the numbers don't work? Here's what I mean.

I entered surgery on December 13 at just about 240 pounds, approximately 70lbs overweight for my height and frame. I am now 19 days out and have lost 17lbs, i.e., over 24 percent of my excess body weight, bringing me this morning to 223 pounds. The problem is the numbers don't work at all.

At 240lbs, my body required 2421 calories to sustain its basal metabolic rate (assuming little to no exercise). On the average, I have been consuming approximately 800 to 900 calories per day since returning home from the hospital. Assuming a daily consumption rate of 800 calories, that calculates to a daily caloric deficit of 1621 or 30,799 calories over this 19-day period. A calorie deficit of 30K equates to a projected weight loss of 8.79lbs (30,799 / 19), not 17 pounds. How can I explain the additional loss of more than eight pounds? The math just doesn't work.

For those of you who have lost a large percentage of weight, more weight than can be explained by the energy surplus/deficit model (i.e., 3500 calories = one pound of fat), how did you come to explain or understand this? Did you happen to discuss this phenomenon with your nutritionist or doctor and what, if anything, did he or she have to say about this?

Of course, I am not complaining. It's just that I don't understand how this kind of weight loss is metabolically possible.

The healing process is completely unique to each patient's metabolic profile and overall body composition. The internal and external healing process consumes a significantly higher number of calories than can be calculated using your formula. While it is tempting to try to fit this process into a standard formula base, it simply will not work. Each persons' body composition is unique and the formula you are using is simply a standard formula for an average body composition. The rate at which one might lose weight after a surgical procedure of this kind is impossible to calculate because the variables are, for the most part, incalculable from patient to patient. Basically, it boils down to not being able to determine how much weight you - or anyone else for that matter - might lose because you simply have no idea how many additional calories your body will burn as it works to try to heal itself over a long period of time. Hope that helps.

Thank you for this very thoughtful reply.

I knew in a very general sense that the answer lied in a greater BMR requirement than I was calculating but that also didn't make much sense to me. It never occurred to me that the recovery process itself would require extra energy, as many as 1,000 extra calories per day, but it makes perfect sense now that you've mentioned it.

Thanks again.

I can't believe you've even worked this out lol

I've often wondered the same thing. I tracked my caloric intake for years and was never near what the charts told me I needed to maintain my heavier weight. Doctors would tell me that the diabetes medication I took was part of it. I think that those BMR numbers are BS. They may work in a general sense but each person is individual enough to see differing results.

Doctors would tell me that the diabetes medication I took was part of it.

Interesting that you should mention this because I also have diabetes and am taking medication for it as well.

I can't believe you've even worked this out lol

It's an occupational hazard I guess. I'm a teacher and one of the classes I teach is statistics. Smile.

Great explanation!!

Did you factor in Water volume loss with the weight loss? This may account for the unusually rapid loss,at first, then the dreaded stalls.

Done Did It!

Did you factor in Water volume loss with the weight loss?

I wouldn't know how to calculate the contributing percentage of water in the total weight loss over 19 days. Specifically how would you do that?

I gained over 3lbs from the saline/dextrose solution that I received in the hospital and that passed over a 48-hour period. I didn't include that gain or loss in the reported numbers because it's artificial.

After the loss of the saline-induced increase, I dropped 7lbs over the third and fourth days after surgery. Then my weight plateaued for the following six days (no change in weight at all). From days 10 through 19, I have been steadily losing an average of .9lbs per night, for a subsequent decrease of 10 additional pounds, which is what has been concerning me.

I was told to discontinue my daily dose of HCTZ 50mg (diuretic) that I had been taking for hypertension due to post-operative problems with diarrhea and dehydration. I am currently taking Imodium on a daily basis, which is controlling the diarrhea and, consequently, water loss and dehydration. If anything, I've been retaining water lately as, per doctor's orders, I'm drinking 1000ml of Pokka Sport's Drink every day.

In addition, water loss wouldn't account for the 4-inch decrease in my waistline. I entered surgery wearing a size 46-inch pair of pants and I'm now back in my 42's. I suspect, what I fear, is that some of this loss is not from water but muscle mass, despite the fact that I am killing myself to meet my daily Protein requirements.

Water weight? Less sodium

Water weight? Less sodium

Exactly. The increased sodium consumption from the sport's drink combined with the discontinuation of the water pill would result in water retention, not water loss.

Right now, until the diarrhea resolves itself, I'll gladly take the water retention.

Another thing to consider is your BMR is is calculated on a completely sedentary lifestyle (bedridden). Anything you do burns calories in addition to your BMR. simply getting out of bed burns calories.

Did you by chance calculate your caloric intake before you started this journey? I consistently was over 5000 & often over 10,000. Without additional calorie burn I should have gained about a lb or more everyday.

We also have 10 to 15 lbs of waste in our bodies at all time. Lol. Maybe it's just that you're drinking liquids?

Did you factor in Water volume loss with the weight loss? This may account for the unusually rapid loss' date='at first, then the dreaded stalls.

Done Did It![/quote']

Exactly. If folks can read the link in my sig, it explains a lot about the significant water lost in the initial weight loss stage. Initially, you're burning glycogen for fuel, and it takes 4 pounds of water to metabolize 1 pound of glycogen. So yeah, there is a lot of Fluid loss in the early weeks. When that fluid comes back, that's when people see the dreaded 3 week stall. But it's nothing to do with body fat. In fact, if that fluid is coming back, it means you're not burning glycogen, so you have to be burning fat.

Also, keep in mind that the BMR numbers are merely averages for the 4.5 billion people on the planet. So by definition, half of us are going to be on one side of that equation and half of us will be on the other....meaning you will burn calories slower or faster. We will not all be right on the line. It has also been proven that all calories are not created equal. 600 calories of bread or potatoes per day will hinder your weight loss efforts, but 600 calories of lean Protein will help you rebuild muscle, which will help burn off more fat. So WHAT you eat means almost as much as HOW MUCH you eat.

Did you factor in Water volume loss with the weight loss? This may account for the unusually rapid loss' date='at first, then the dreaded stalls.

Done Did It![/quote']

Great new sig pic...by the way.

My first few weeks were inaccurate as well. I experienced the week 3 stall with a couple pounds of weight gain right in the middle of it, yet my clothes continued to get baggier and my sizes went down. Now, though, a couple months out, I'm running at about a 2k caloric deficit per day and my weight loss is generally steady at an expected 4-5 pounds a week.