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.

Did you by chance calculate your caloric intake before you started this journey?

That's a great question.

I didn't count calories, per se, before the surgery but I did sign up for Weight Watchers one last time in June of 2010 and stayed on it for eight months. At 244lbs, my starting point value was 43 per day. I once read somewhere that each point is equal to roughly 50 calories. So my initial daily calorie intake was 2150 and eventually went down to 37 points or 1850 calories per day when my weight dropped to 218lbs (the point at which I stopped and eventually regained).

I lost an average of .9lbs per week on the Weight Watchers program. That calculates to a calorie deficit of 3150 per week or 450 calories per day. If we assume, at 37 points, I was eating roughly 1850 calories per day at 218lbs, that means my BMR was approximately 2300.

What's interesting to me is that MyFitnessPal.com is telling me I need to consume 2190 calories per day in order to lose 2lbs per week (7000 calorie deficit per week). That means, according to MFP, my BMR is closer to 3190 per day. If that's true, and given that I'm consuming about 800 calories per day, that would leave me with a daily deficit of 2390 or .68 of a pound, which is very close (.9lb) to what I am actually losing now.

With the recovery process, based on the amount of weight I've been losing, I'm guessing that my BMR is something like 3950. I'm assuming that will decline as my health improves.

Exactly. Initially, you're burning glycogen for fuel, and it takes 4 pounds of Water to metabolize 1 pound of glycogen.

According to that article, up to 2lbs of glycogen are stored at a time, accounting for no more than the proverbial quick 10-pound weight loss (2lbs glycogen + 8lbs water) during the first week of any crash diet.

As I mentioned in one of my subsequent posts above, I lost 7lbs over days 3 and 4 and then "stalled" for almost one week as predicted by the article. If we take the information in that linked article literally, I should now be in the fat-burning phase of weight loss: "You start mobilizing fat from your adipose tissue and burning fat for energy" (para 3). The water expended for glycogen burning would not account for a 17lb weight loss over 19 days, not in the context of 70lbs excess weight, nor would it explain a 4-inch loss in the waistline. Undoubtedly, most of the initial 7lb drop over days 3 and 4 was from water. I was after all re-hospitalized on day 4 for dehydration.

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.

BMR figures are normally distributed (like I.Q. scores for example), meaning that the mean, mode, and median are all the same. It's not a 50/50 split because, although a bell curve is symmetrical, the proportions are geometric, not linear: the majority of the population (mode) does line up right smack in the middle, at the average.

According to one source I could find (Examine.com), one standard deviation is 6 to 8 percent of the mean BMR figures. What this means is that if the BMR for a 58-year old man at 5',7" at a sedentary level for maintaining a weight of 244lbs is reported as 2400, then 68 percent (+/- 1SD) of the population of 58-year old men at 5',7", weighing 244lbs, will fall between 2208 and 2592. The difference in extremes, for 68 percent of the population, comes to 384 calories per day, which is significant when you are counting calories. However, that BMR figure of 2400 will apply for the majority of the population in question, not half.

I will update this thread as I have something eventful to report.

May I add that initially, I was not getting 800-900 calories post surgery. My diet consisted of 8 oz of protein shake in water sipped throughout the day, additional water sipped and possibly 4 oz of soup with 1oz of protein shake. I don't think that added up to 800 calories. That was my diet for the first week post surgery. It didn't change much for the second week either.

May I add that initially, I was not getting 800-900 calories post surgery.

My stomach could not tolerate the Isopure Protein shakes: they were passing right through me. I was so malnourished and dehydrated during my first week that, for the first time in my adult life, I was actually hypotensive (95/60) without the use of any medications! Now, I am running 140/80 again with my medications back in play (Diovan and Plendil).

This is why my doctor moved me to soft solid foods at day 9, instead of day 14. I was basically starving on those Protein drinks and Soups.

Great new sig pic...by the way.

Thanks!

Done Did It!