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I think my dietician is crazy!



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I went for my first follow up today at 9 days out from surgery. I met with my dietitian to discuss my eating habits and caloric needs. I told her that I had been eating around 600-700 calories a day. She said that that is WAY too few calories and that I should be shooting for around 2000 calories daily. This is based on a caloric needs (REE) test that was conducted a month before my surgery (7.22). I am beginning to think that my dietician has no idea what she is talking about. Any other source that I have ever read has said that most people eat 600-800 during weight loss and slowly up it to around 1200 to maintain. How in the world am I supposed to eat 2000 calories a day a week out from surgery. I would literally have to eat constantly. lol Any thoughts, fellow VSTers?

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My NUT says to focus more on the Protein than counting calories. But, I must agree with you....2000 seems like too much! :). Good Luck!

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Our nut gave us the attached guidelines. I think your nut is crazy also.

allons-y

post-51361-13813668401601_thumb.jpg

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I'm 11 days out, so I'm not much of an authority on anything. However I think your dietician is crazy too. There is no physical way that I could consume that many calories every day of healthy food. I just started tracking and I'm around 800 calories a day.

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Impossible unless you are drinking milk shakes or eating blizzards from DQ.

Here is a rough caloric plan, by month:

Month 1: 300-600

Month 2-5: 600-900

Month 6: 1000 -1300

Month 7-12: ramp up to 2000 or whatever your TDEE is

The key is to start low in order to heal properly and also gain the benefits of caloric flooring from restriction. By the end of month 1, you will be starting to eat solids. I am sorry, but you just cannot eat more then 2-3 ounces at a time without pain. It gets better over time and you want to advance caloric load as you are able to, but do it gradually in order to bring your caloric metabolism up slowly in order to avoid storing. It is definitely a process that must be cared for over time, month by month as you heal and things like exercise require more calories. I would not recommend eating at 500 calories day in and day out after a few months because you will train your body that starving is ok. Clearly you want your body to be good at burning off excess and not storing it so, again, increase slow and steady.

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I think the answer lies somewhere between what your dietician says and what you read... 1200 for a man to maintain seems VERY low... and 2000 so soon after surgery seems very high.. I know active sleevers who DO eat 2000 calories a day... just not 9 days after surgery. I am 4 months out and on 1240 calories a day.

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Per Serendipity, my caloric load is approximately 1900 and I roughly followed the plan outlined above. My NUT gave me some initial guidelines, but after a few weeks I played by ear and tweaked along the way. I probably kept my calories between 900-1100 until month 7. Most of the weight was lost by then and my focus turned towards fitness where more calories were needed.

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Fiddleman, thank you for posting the chart for calories. Do you have something like that for Protein and carbs for the same time periods? I am 3 hrs from my NUT and she really doesn't seem to know much about post surgery diet needs.

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Thanks for the awesome replies, guys. I have basically had to figure most of this out on my own because of the wacky advice that my NUT gives. She actually told me that, "if it bothers you when your wife eats around you, have her eat before she gets home or have her cook somewhere else." In what world does that make any sense and what kind of douchebag would I be if I told my wife, "Sorry, you have to go cook at your mom's because I don't want to smell hamburger helper cooking." lol Since she is the NUT in my surgeon's office, I have to go to her. Thankfully, I have this forum to help make sense of it all.

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I think some dieticians say that referring more to a "regular " person caloric intake peramiters .... mine told me something like that also before surgery when we spoke about how my diet would be after surgery... I had to get clarification from My actual Dr on the " realistic " weight loss person calorie needs. The first few months 500-800 calories making sure I get 60 protien , at about 6 months about 1000 and 80-100 protien depending on my workouts.... and when I want to maintain we will work together to find a caloric level that suits me as not to regain... I am just shy of 11 months out and take in 1000 calories a day sometimes more if I feel I need it or workout really hard

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Fiddleman' date=' thank you for posting the chart for calories. Do you have something like that for Protein and carbs for the same time periods? I am 3 hrs from my NUT and she really doesn't seem to know much about post surgery diet needs.[/quote']

For the first 6 months, try your best to hit 80 grams of protein a day and as low carbs as you can manage. I have always found low carb to be the easiest way to lose fat, especially around the stomach where I carried a lot of my 360 lb last year. After surgery it was not any different, but i had the tool of restriction to limit amount to 3-5 ounces of food at a time. I would say my low carb eating was around 20-40 for the first 6 months. once i started running at month 5, I increased to 50-70 a day. Now i do not count really, but make a conscious effort to eat good carbs, especially on cross fit training days. Once you start fitness, whenever that may be, you will need to start increasing both good carbs and lean protein gradually to support the required energy. My fitness is really active today and I am on a mission to reshape my body composition (it is working) so I eat as much protein as I can during the day, around 170-180 g, and a healthy dose of good carbs, around 100-150 g. again, i am not really counting, but have an idea. My weight averages 177 lbs for 5'11" and I have built a good foundation of lean muscle for decent strength ( dead lifted 350 lb yesterday) in the last few months. 170 g protein a day is still not enough for me to build real huge muscles for my body frame size, but I do the best I can by eating every 2 hours on average, always trying to hit between 30-40 G protein. The best amount of protein would be probably about 200 g such that my lifting will optimally create muscle. As it stands, I have to work very hard to keep my body from becoming catabolic daily. I have done so much personal research about nutrition, fitness and optimal anabolic conditioning over the last 6 months that I trust my instincts day to day. As for daily consumption of food, I eat from 6 am to 9 pm, in order to keep the furnace burning strong. Keeps any hunger away. Lol.

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I went for my first follow up today at 9 days out from surgery. I met with my dietitian to discuss my eating habits and caloric needs. I told her that I had been eating around 600-700 calories a day. She said that that is WAY too few calories and that I should be shooting for around 2000 calories daily. This is based on a caloric needs (REE) test that was conducted a month before my surgery (7.22). I am beginning to think that my dietician has no idea what she is talking about. Any other source that I have ever read has said that most people eat 600-800 during weight loss and slowly up it to around 1200 to maintain. How in the world am I supposed to eat 2000 calories a day a week out from surgery. I would literally have to eat constantly. lol Any thoughts' date=' fellow VSTers?[/quote']

Yeah, she's def crazy !

That's impossible! You need to talk to one of the RN's or NP's in the office.

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I went for my first follow up today at 9 days out from surgery. I met with my dietitian to discuss my eating habits and caloric needs. I told her that I had been eating around 600-700 calories a day. She said that that is WAY too few calories and that I should be shooting for around 2000 calories daily. This is based on a caloric needs (REE) test that was conducted a month before my surgery (7.22). I am beginning to think that my dietician has no idea what she is talking about. Any other source that I have ever read has said that most people eat 600-800 during weight loss and slowly up it to around 1200 to maintain. How in the world am I supposed to eat 2000 calories a day a week out from surgery. I would literally have to eat constantly. lol Any thoughts' date=' fellow VSTers?[/quote']

She's totally nuts! You need to make an appt with the RN Or the NP or the surgeon!

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Fiddleman. Thank you so much. You have helped me make sense of this.

You are welcome. It is good for everyone to build their own opinions after hearing information from different sources. The description i gave above is what worked and is working for me. Others may have just as good a strategy that works for them. Furthermore, I do not fault a dietician as they build good general guidelines, but they are, by design, lowest common denominator in order to work for the most number of people. After a while you need to determine what it is that works for you. The further out a person is from surgery, the more important is for them to own their plan for long term success. I am not saying anything that isn't common sense, but it may be helpful to read.

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