Some of you know me and some of you don't and at six months out some of you may not count me as a "Veteran" and that's okay- I'm not. I'm as green as the fresh-cut grass. And my questions are going to prove it! I'm posting here because posting in the really newbie forum isn't going to help me as much as I believe you all may be able to.

My main concern is how to increase my calorie count to where my surgeon/nutritionist wants it to be when I'm just not able to eat that much. Even with a sudden increase in my appetite, I'm finding that my calories are right around 500 for the day- not the 1200 recommended by the surgeon/nutritionist. Increasing my exercise hasn't made it easier to eat, only made me more thirsty. My diet is relatively low-carb. Meaning my carbs come only from occasional fruits and the rare starchy vegetable, as I was diagnosed with Celiac's Disease and my sleeve just doesn't tolerate any bread, rice, grains, etc. So, I don't touch the stuff- when I try, disaster! (I use MFP to track my daily intake.)

Exercise is primarily walking the local track, walking at the local cemetery (lots of hills), and using the elliptical. I also do a kettle bell shred on alternating days of the week. I'm far from sedentary since just prior to being sleeved and getting more active every day.

I still struggle to not only meet the daily calorie requirements, but to keep food down. I've had one stricture repair, I take my PPI and my anti-nausea medicine religiously. The surgeon tells me it will just be "tight" for a little while, to keep getting my Protein and calories in. How??!! And how the heck does this metabolism thing figure into it? I've lost weight but being ill and exhausted all the time is not fun.

Any suggestions that you Veteran sleevers may have as far as calories and protein go, I'd certainly appreciate it. I swear I feel as though I'm at my wit's end with this and when I see my surgeon I'd like to have something positive to report to him.

You know' date=' the more we discuss this, the more I am realizing there's more unknown than known. If we do all this to get healthy but we can't BE healthy (food and calorie levels) well, hmm. I know my BMR is messed up too. Years of yoyo and then sleeve, at 3 years out, I love the initial weight loss and have mostly maintained but I think my age ( 59) and the above mentioned has made it really difficult to just "be normal" and not gain. Have to be very, very careful of carbs, calories, never mind losing what I've regained (about 15 lbs). I wouldn't trade a thing and would do it again but know this will be a forever battle, too. dde04[/quote']

As far as I know, the only way to fix it is to build muscle mass. This means eating a lot of Protein and lifting weights. It will also help with bone density. Did you know that obese people have heavier skeletons because your bones build up under the stress? That's actually a good thing for us because it means we have a fighting chance against osteoporosis and brittle bones, as long as we maintain our bone health.

I damaged my BMR from doing a year of medically supervised Optifast. At the worst it was only 1300 as tested by the breathing machine. The doctor ordered a repeat test because he didn't believe it. I am hoping the sleeve combined with weight training will help. Metabolism is serious. I only lost 20 pounds from a year of eating less than 1000 calories a day.

Well fu** me! This makes me despair!

Well fu** me! This makes me despair!

I was told the way to get it back was serious strength training. I bought a full set of dumbbells but then had to travel for a month for work. I'm getting back to it this week.

By the way I have also been told, by my surgeon, that with the sleeve, your metabolism responds positively to a feeling of fullness. Full stomach = body doesn't get the signal to store fat but to burn it. Under-eating = store energy for the famine. I have read about this in relation to RNY too. It's the "metabolically active" part of these surgeries that banders don't get. It's not necessarily about calories, but about stomach distension, meaning pressure on the top part of the stomach. Not extreme but just enough.

I am still very new and shouldn't even be posting here but since you quoted me, I hope it's ok. I want to encourage you not to give up. I hope you find your answers soon even if it is an underlying issue that is holding you back.

I have seen a lot of vsg vets around on the web post about ways to increase caloric intake and many folks go for quality and caloric density as it is a challenge with quantity, which is fairly obvious considering our restrictive procedure. High quality cheeses, nuts, and bacon seem to be popular choices - as well as avocados, nut butters, etc. If you like your protein drinks, adding more liquid calories could be easier than denser forms of food if you simply stuffed to the gills all the time. There are a lot of protein drinks out there with much higher calories than the one I drink (Premier) - this could help.