Ok, so this is a small rant with a plea for advice.

I was 451 Starting on 2/1 and 409 at surgery 7/31 and 391 at 4 week post op. i am not losing fast enough for the Dr but I don't know what to do. I did liquids for a week. Then soft foods like cream Soups, cottage cheese, ricotta bakes, mashed potatoes, etc. til 4 weeks post op, slowly adding in lunch meats, soft canned veg, and softer meats like tuna and chicken.

NUT and PA gave me flak for not following their plan. I didn't hurt myself or cause issues.

Ok, so the rant/dilemma: i am not losing very fast and I was eating 800-1000 calories a day at 4 weeks. Not really as most meals I didn't finish but that is what I tracked. My NUT said less carbs and my PA said lower my cals. So I spent the last week weaker and tired only eating the recommended 500-600 cals and less than 40 G pf carbs. I lost NOTHING. I am going to go in on my 6 week appt without losing a thing and it will be my fault when I followed their plan.

I think the low cals has me in starvation mode and with exercise and still bot losing I don't know what to do.

I'm surprised after a 40+ lb pre surgery loss they are not happy with your 18 lb loss in 4 weeks post surgery. Sorry I'm not much help with advice on this.

Are you sure on your calorie and carb counts? (ie are you tracking with MFP or something like that?). Are you drinking enough water? Getting enough protein? If so, it sounds like everyone just needs to be patient while your body adjusts. The weight will come off eventually!

I'm really confused about calories myself, and posted a similar plea for help earlier. Low cal's seems to put us in starvation mode, yet if we're eating higher cal's it's kind of like "what was the point of having surgery?" Maybe the slow down in weight loss is just your body adjusting, though. You've already lost a lot of weight! Maybe your body is just fighting you (as it's programmed to do), regardless of what you do. It needs a few weeks to slow down, adapt, and then the weight will start coming off again...?

I say, good for you for your efforts and weight loss so far! Now as for the optimal calories...I wish I knew!

What did you not like about their program that caused you not to follow it?

My clinic's program dictates a minimum of 800 cals and 75g of Protein per day for all patients. My dietician said lower calories can slow weight loss. I was frustrated at 3 weeks of 1 pound weight losses but she told me I was right on track and keep on. Sure enough, I lost 10 pounds in the following 2 weeks. I am tracking my foods in a paper journal, but using labal info and info from MFP to be sure of the counts. I am just more regular when using a book.

I get in between 700-800 calories a day with a restriction of 40 grams of carbs. I've continually lost every week and track everything in MFP. I exercise daily and make sure I get in my 60-80 grams of protein also. Maybe your fat intake is too much, along with your sodium? Don't get discouraged, I bet your body will surprise you soon enough! Stay positive

I've lost 15lbs 4 weeks out, and my doctor was pleased with that and said he doesn't want me to lose too fast. You've lost 18lbs since surgery, that's better than before, right?! You didn't say anything about exercise, are you getting some in; at least 30 mins a day...? Also, your protein intake is very important for weight loss and maintaining muscle. A thousand calories a day is not unreasonable as long as you are burning more than that a day!

I am nearly 6 weeks post op and my doctor said to get 60-80 grams of protein each day. He said eat the protein first because it fills you up and keeps you full. He is not concerned with calories or fat, just protein and water.

I accidentally posted before I was done and am cooking also so here are the deets....

The reason I didn't follow the program. They wanted two weeks of liquids only. broth, Water, Protein shakes, milk. No Soups no particles of any kind so not even tomato!!!! I was STARVING at day 4 post op! I was already having no triuble getting fluids and protein so didn't understand the hunger (taking omoprezole) so I had to have something with substance. Then at soft foods they complained that I ate lunch meat. What?!? Their timelines don't seem to follow anyone else's on here.

I am intaking less than 40g of carbs, 60+ grams (usually the +) protein, and 85-100+ oz of water. I work out 4-5 days a week doing a mile or two walk or a leslie sansone video so 20-45 minutes. I went to the rec yesterday. Swam and did elliptical. Granted before the NUT discussed carbs I was intaking 75+ grams. But every idea she gave for strained liquid stage (another two weeks that I couldn't wait through) was all carbs...milky oatmeal, thinned chili with Beans....etc. so there it is.

I eat about 1/2c to a cup (depending on what it is) 3-4 times a day (dr wants 1 c 3 times a day ONLY) but I am weak and tired if I only eat 3 times a day. I feel better at 4-5 times a day

Hi many fat grams are you getting?

Starvation mode is a myth for us fatties. We have enough fat stores to last through a game of thrones winter so take that out of your head. Are you on a PPI sometimes we mistake that for hunger. Get out of your head hunger.

They are probably used to seeing faster weight loss b/c of a lengthy liquid diet. It seems like those with the fastest weight loss have the longest liquid diets in many cases.

Don't forget, your body can never violate the 1st law of thermodynamics. Ever, for any reason.

Just think about it like this:

The average adult body needs to burn between 1500-2500 calories/day just to keep you alive (that doesn't include exercise, and yes, you burn plenty of calories while you sleep, because you don't die when you go to bed.) If you consume less calories than that, then your body has to get the energy from somewhere else, or you would die. So the body either has to burn its own muscle or its own fat (or some combination thereof) to keep you alive.

As long as you remain in a "negative energy balance" (meaning calories in < calories out,) you will lose weight, even if it's not as fast as you want.

They have machines called indirect calorimeters which can actually measure (in real time) if you are building fat, burning fat or at equilibrium by measuring the amount of CO2 vs. O2 in your exhaled breath.

http://www.pbrc.edu/research-and-faculty/core-services/?serviceid=82

This is a link to a research center that studies such things.

Ok, so this is a small rant with a plea for advice.

I was 451 Starting on 2/1 and 409 at surgery 7/31 and 391 at 4 week post op. i am not losing fast enough for the Dr but I don't know what to do. I did liquids for a week. Then soft foods like cream Soups, cottage cheese, ricotta bakes, mashed potatoes, etc. til 4 weeks post op, slowly adding in lunch meats, soft canned veg, and softer meats like tuna and chicken.

NUT and PA gave me flak for not following their plan. I didn't hurt myself or cause issues.

Ok, so the rant/dilemma: i am not losing very fast and I was eating 800-1000 calories a day at 4 weeks. Not really as most meals I didn't finish but that is what I tracked. My NUT said less carbs and my PA said lower my cals. So I spent the last week weaker and tired only eating the recommended 500-600 cals and less than 40 G pf carbs. I lost NOTHING. I am going to go in on my 6 week appt without losing a thing and it will be my fault when I followed their plan.

I think the low cals has me in starvation mode and with exercise and still bot losing I don't know what to do.

I'm really mad at your medical team on your behalf. You are 5'7" and weigh 391. Your resting metabolic rate is around 2475 cal/day (that's before added exercise). At your height and weight, even a brisk walk is probably burning you 12-15 cal/min. At 1000 cal/day, you should be losing about 1/2 pound a day if you are exercising. If you are getting enough Protein, you are not getting too much fat, and even so, at the level of calories we consume after surgery, we need to get fat in too. As far as carbs go, I'm in no way convinced that 75g/day is too much. Your medical team is effing with your head here. Based on where you are post surgery, I would expect that you are experiencing what many of us experience several weeks out... a period where your body is adjusting to what you are giving it. I don't believe there was any need whatsoever to reduce your calories.

As far as starving... yes, we absolutely can. I hope no one tries to convince themselves that they can cut calories as low as they want and suffer no ill effect. We do have a bit more buffer time, but it's not infinite, and it doesn't even last as long as we might expect. If we don't get an adequate amount of nutrition, we will experience muscle wasting and we will experience extreme fatigue, fainting, all kinds of nastiness... and the gift that keeps on giving is the up to 40% reduction in our metabolism that will have to be rebuilt over time with a lot of effort and hard work.

You are only getting maybe 20-25% of the nutrition your body is using daily. I dropped down to that level myself. (I'm only about a week further out than you and have a kink/torsion which is making it really hard to get a reasonable amount of food/fluid each day. I thought I had gotten really dehydrated due to lack of energy, dizziness, etc. but my bloodwork showed that I wasn't. When I discussed what I was able to eat with my surgeon, she said the problem was far more likely to be not getting enough food. I'm still struggling to get 600 cal/day and about 60g protein. Carbs are around 50 right now and fat is around 20. I am still experiencing light-headedness and fatigue. In fact, I got up late today, so I didn't get to eating right away and I nearly passed out in the shower. That is no exaggeration. I seriously was trying to prop myself up on the walls until I could lower myself to the edge of the tub to sit down.

Anyway, don't be hard on yourself if you feel like your body isn't getting with the program. For many, it takes awhile to see consistent loss, and it doesn't mean that you are eating too much of anything. Your body just needs time to adjust. If your medical team can't accept that, I am really sorry, but you will have to let their criticism go in one ear and out the other and examine their advice carefully before following it.

Best of luck. Whatever you take from this post, know that you are not at fault here. I know that you will be successful! Good luck! (sorry... apparently I only know how to write War and Peace in these things...)

Remember, at 9cal/gram of fat you have to burn 9 more calories than you take in to lose 1 gram of fat. in turn this means you have to burn about 4000 more calories than you eat to lose one pound of fat. On the other hand, you can lose up to 10 or more lbs of Water in one day.

None of us should be so hard on ourselves. Its a gradual process, but it will work in time

Ok, on MFP I range from 21 grams of fat to my worst day of 42 (I ate 3 oz of pork steak which even though I cut the fat off MFP still counts it). Here is my program's plan for regular foods (which starts this coming Tuesday for me had I followed their timeline)

3 meals a day. 20 G of Protein AT LEAST per meal with a goal of 60-70 per day. Less than 40 G of carbs. No specific goal on fat, but remember to eat lean meats and cut fat off of fattier ones. Approximately 800 calories max a day.

Their sample meal plan for this stage however includes a light Breakfast sandwich made with egg white, turkey sausage, and a whole wheat english muffin. According to MFP, this meal consists of 27.5 carbs, 250 calories, and only 12 grams of protein! This is using Thomases muffin, jimmy dean turkey sausage, and great value egg whites. This would leave me with only 13 carbs left forthe day and not enough protein in my first meal. Calculating this has seriously made me feel like my program has not considered their plan thoroughly. Although they are a center for excellence.

The timeline is 2 weeks liquids (nothing particles or cream)

1 week thick liquids (include thin yogurt, cream soups)

1 week pureed foods (still pretty thin)

1 week mushy foods (applesauce consistency)

1 week soft foods (for some reason can include very very toasted bread chewed to a paste-like substance and iceburg lettuce)

After 6 week appt can do all foods except: Pasta til month 4, corn, fresh fruits and veg until month 2, steak until 6 months, other lettuces in month 2, alcohol for 1 year, carbonated drinks 4 motnhs if ever.

I think that is everything. Also, the NUTs give differing food intake advice from the PA. I haven't seen the surgeon since I was in the hospital. My program farms people through efficiently so the surgeon is not a very important part of the program after he performs the surgery.

B