Hi everyone! Im new to the forum but had a question that I am hoping some of you post-op (or maybe pre-op) people can answer. I am scheduled to have my Sleeve surgery on 2/27. I know the pouch will dramatically restrict the calories I am able to consume, but I was wondering if that is permanent. Meaning, 10 years down the road, will I still be consuming less than 1000 calories? From the posts I have read it sounds like people range from 600 to 1000, and I know the average recommended caloric intake for a woman is 1500. Just curious if this is a permanent restrictive state.

Thanks!

Your stomach is permanently small. I'm still less than a year out, and I'm back up to near 1000 calories a day. I think as you shift from loss to maintenance you can eat more - but you still can't fit more than 1c of food at a time, and eating too often leads to grazing which leads to weight gain. You don't want to be back for a revision (I actually met someone who has had all three surgeries - band revised to sleeve revised to RNY!).

It's a lifelong journey. If you aren't prepared for the lifelong changes, make sure you get the facts and really think. It's a tool and it's not removable

That 1500 calorie range is too high for many formerly obese women and can cause a gain in the long run. We are different.

My mindset is not really based on what's the norm or recommended . I intend to just go by the results I get. I don't care about goal weight. I have some clothes from 30 years ago when I was the size and shape I want. When I fit into them, I'm there. And as far as calories. When I reach that goal, I'm gonna eat what feels necessary and comfortable........if I gain....I'll adjust to not gain. Whatever the calories are, they are.

Hi Sarah and welcome!

Calories are determined by what you eat, and what i mean by that is if you ate a serving of fat free/sugar free pudding it would be around 60 calories, eat the same amount of haggen daaz and it would be about 350 (estimating). The amount you can eat is and will always be restricted. Over time you'll be able to eat a little more than in the beginning but it should not be substantially more - if we constantly push the limits of our new stomachs it can stretch a bit over time, but how much I would imagine is specific to each person. I measure/portion out my food still, less waste and I don't overfill my sleeve. Eat too much once and you never want to do it again.

The maximum I can get in, at 13 months out, is about 7- 8oz. and that is really pushing it and depends on what I'm eating. The more dense items you eat, the less you'll be able to consume. I can get in about 7oz of Soup no problem, but typically 3-4oz of chicken or beef is all I can take.

We count calories so we do watch what we eat, Protein first, then veggies, then starch. It is a balance, and everyone finds their "sweet spot" for what works for them.

The built in restriction will limit how much you can eat at one time, it's up to you to work out the best meals to stay on program to maximize your loss at first, then maintain.

Slider foods, foods low in nutritional value, but easier to eat (chips, ice cream, pretzels, etc.) go down pretty easy and don't really fill you. Consuming protein first, will fill you longer and provide the nutrients you need for energy.

I don't know if there are a lot of stats for 10 years out but there are a bunch of vets on the forum that are 3+ years out and of great help.

I know the golden rule is to follow the mentality of calories in versus calories out and you'll lose. I can tell you, I always burn more calories than I take in and I have weeks where I don't' lose. Our bodies adapt. For me, carbs have and I guess always will make me crave more. Getting used to head hunger vs. real hunger (which I still dont' ever feel) was a struggle for me initially, keeping the carbs at bay helps.

Best of luck to you for a smooth surgery and recovery.

This is an interesting question. On many levels. It really made me think.

Do we restrict calories forever ...

So, relative to how I ate pre-sleeve, yes, I am going to be restricted in my calorie consumption. I will probably never be able to eat 3,500 calories at each meal. But then I have to ask, "Why would I want to?" These would be my old demons wanting me to be able to abuse food the way I used to. I don't want to be that person ever again.

So, relative to other fit, 185 pound men ... no, I am not restricted in my calorie consumption. When I am very active, I can consume healthy meals and feed my body properly. I can easily get over 2,000 calories a day. When I live a more sedentary life, I dial that back to around the 1,800 calorie mark. I am able to maintain my weight, no problem. If I should creep up 5 pounds, I use the stricter guidelines of sleeve life when I was in loss mode to drop those 5.

So, I think the spirit of your question, though, questioning if you are going to be able to only eat 1,000 calories MAX each day. The answer is no. When you get some time under your belt, you will be able to increase your calories. Good or bad, you find foods that "slide" through you. Whether you go back to abusing foods is up to the work you did early out (first year) addressing the reasons why you were morbidly obese and whether you implement the changes required for long term success.

So, if I had lunch with a friend from pre-sleeve days on my left, and also had a running friend sitting on my right, one would say I eat a restricted diet now while the other would say I eat a nice, healthy, balanced meal.

It's all about perspective and your ability to mentally make that leap.

*** EDIT ***

So, I just wanted to add, that no, I do not eat a restricted calorie diet. A restricted anything diet, for that matter. Not restricted carbs, sugars, fat ... When I focus on eating nutritionally balanced meals, my sleeve just naturally takes care of everything else. When I do this, I am rewarded with a cookie or some ice cream. But I finish with my rewards, not start with them ... which I used to do.

Edited January 23, 201412 yr by PdxMan

My goal is to have my sleeve restrict my calories as long as possible. The amount of calories is misleading because liquids are easier to get more volume and depending on what you are drinking can really jack up the calories. for instance, if I drink a muscle milk for Breakfast it is 180 calories, but if I have 1/2 cup get beaters it is 60 calories. Also if I eat just lean Protein for meals and Snacks I struggle to get over 600 calories and 75 g protein.

I chose the sleeve because I really hope that it will give me the life long tool to keep my calories in check.

Thanks for all the feedback! Pdxman - that is great info to know. I guess I was just curious longer down the road once I meet my goal weight how it works. I really want to get back into running like I used to before my weight got out of control, so I was curious if I would keep up low calorie intake while training, especially since it sounds like the foods that are better for you are naturally filling and lower in calorie content. Again - thanks! So greatful for this forum and insight.

Sure thing, Sarah,

Here's the thing. I trust you have heard or read about the general guidelines for restrictive sleeve success, but here is my summary:

• Do not drink 15 minutes before, during or 15 minutes after eating.
• Ensure my meals are nutritionally balanced.
• Take smaller bites, chewing well putting my utensil down in between bites.
• Assess how that bite felt waiting to take the next bite. If I am feeling the smallest amount of restriction, I stop eating, even if I have had only one bite.
• Exercise. Do something to get my heart rate up to my target heart range for fat burning. I should feel like I just got my butt kicked afterward. Sweat is required.
• Meet my Protein and liquid goals daily.
• Take my Vitamins.
• Meditate. Reflect on why I abused food and what can I do to break the cycle.

Now, this is all good and well, for me. But, I started a running regimen and quickly discovered I was not going to be able to meet my exercise goals following this path. I needed more calories as I could only run about 2 miles before I bonked. I had to bend the guidelines I listed above to get more calories in. I ate more often and would break the drinking guideline. I was able to consume more food and get upwards of 3,000 calories in a day. But, you have to also consider I was running over 30 miles a week and doing HIIT twice a week. So, if you have a honest reason to bend the guidelines, then you can and increase your calories.

Now, I am not nearly as active as I have had a couple back surgeries and have been struggling to get back active. So, now, I follow the guidelines and consume about 1,800 calories and maintain.

As a comment on the rules: I was told not to drink 15 minutes before, during, and for an hour after eating.

And I have a friend who is very into CrossFit postoperative, her carbs are higher than mine because she needs them. But our caloric intakes are pretty close based on the restriction and eating protein first, dense foods, etc.

everyone is different

Listen to your body...

Pdxman, not to quibble but my understanding of thr fat burning zone is somewhat different. I always heard that the fat burning zone was between 70 and 75 % of your maximum heart rate. The simple rule of thumb to figure MHR is 220 minus your age. To get to the fat burning zone take 70-75% of that figure. You can also find the zone based on perceived rate of exersion. You should be able to carry on a conversation With some difficulty, you will sweat and feel tired, but not a bit kicking. Another way to look at it is to work from your heart rate reserve. HRR is the difference between your MHR as described above and your resting heart rate. If you use HRR then fat burning is 50-60% of your HRR. The next step up is aerobic zone is 60-70 % of HRR and this also burns fat but also builds strength and improves your body's ability to transport oxygen to the muscle. You should get a good level of physical fitness to go above this range and into the steady state or anaerobic range.

Long story short you don't have to get your butt kicked to burn fat, but you do have to sweat, and push yourself. This is a really basic explanation and I know there are many variables to MHR and training levels, but for the person who just got sleeved and is looking to get someone physically fit, I think a basic understanding helps.

The higher up the fitness ladder you go then you get that butt kicked I can't do anymore feeling. I suggest a lower end heart rate monitor can save someone who wants to burn fat hours in the gym.

The harder you work out the more your body will use carbs to fuel your exercise. That becomes a problem for us because we are consuming mostly Protein. I think pdxman bonked because he exercised too hard for his carb intake. Banking is a horrible feeling during a race or hard training session. Once you bank there is no quick recovery to resume high levels of exercion. The last time I lost a bunch of weight I took up endurance sports, marathons, 1/2 marathons, triathlons up to 1/2 ironman. The most complicates aspect of trading was fueling for training and races without gaining weight. The more I read the more confused I got.

Sorry, banking should be bonking a word my spell check dies not like. Lol

Early out, as the OP hasn't even been sleeved yet, it didn't take much for me to feel like I was getting my butt kicked. I would run/walk a mile and would feel it the rest of the day, but my heart rate never rose above 130. I was in terrible shape. Yes, after some time, as my endurance and fitness increased, I was able to exercise at a higher level. I started running races and even won several in my division. My last race I won for my division was a 10K where I averaged a 7 minute mile. My heart rate stayed well above in the aerobic/V02 range, but half an hour later, I felt great. Didn't feel like my butt was kicked at all.

But early out, some folks getting back into exercise get on the elliptical and go through the motions. Not sustaining an effort which reaps the benefits they possibly could if they were willing to get their butt kicked a little. That was my point.

I absolutely agree that just going through the motions without elevating your heart rate is a waste of time. Congratulations on the races! I think 10ks are very hard because they turn out to be 6 mile sprints lol. When I was running races etc I always wanted to wear a shirt that said " you just got passed by a fat guy" but my wife thought it was is poor taste, she was probably right. But I did love the feeling of kicking skinny people's butts. Buy I got passed in marathons by old people that had the worst form you can imagine. I am sure you have seen them. In some respects there is no substitute for years if miles on the legs. I was not built like a runner and had to work hard for every mile, but that was the challenge, do be good at something I should not have been good at. I got injured and never got to the 7 minute mile pace for a 5k, but did a 25k at 8:15 pace weighing 240#. Not bad for a fat guy! Lol

To get back to the original topic, there are two things to consider when thinking about what the sleeve (or the pouch, in RNY) will and won't do for you. Capacity and composition.

Capacity refers to how much volume your sleeve/pouch will hold. This is the kind of thing you measure with a measuring cup, not a scale. Right after surgery, your capacity will be very small. By 6 months post-op, most of is have a capacity of 2/3 of a cup to a cup, or 6 to 8 ounces by volume. Be careful not to confuse this with food WEIGHT, which is what we talk about when we say 2 ounces of chicken or cheese. For capacity, imagine shoving all your food into a measuring cup. Start out with using 1/4 cup ruff after surgery. You won't finish it. When you can finish it easily, move up to 1/3 cup, then 1/2 cup, etc. The goal is to be satisfied, not stuffed to the gills. Don't be alarmed when your capacity does increase (to a point) over time. It seems to stabilize at about two years out for the sleeve. People with the bypass have to be quite careful because their capacity can increase too much if they constantly push their limits. Basically none of us should be pushing our limits.

Composition refers to the ratio of Protein, fat, and carbs. This is also where calories come in. Basically, a gram of protein or carb is 4 calories and a gram of fat is 9 calories. So to increase or decrease calories of a given meal, manipulate the protein, far, or calories. These are also known as macronutrients or macros. Simplistically, each macro has some characteristics.

Protein makes you feel full, helps your body heal and maintain your tissues, and is difficult to store as fat. It doesn't affect your blood glucose much. If carbs are not available, protein can be turned into glucose for energy by means of a chemical process in your body caked ketosis.

Fat makes you feel satisfied, gives you energy, and also (counter-intuitively) is difficult to store as fat. It is the most energy-dense macro, so it is the easiest way to increase calories if that's what you need.

Carbs feed your brain, increase your blood sugar, trigger hunger based on blood sugar fluctuation, and is really easy to store as fat. They are also more available for your body to use as quick energy.

So go back to your measuring cup. When you are eating less than half a cup by volume, in order to meet your protein requirements, you will need to fill up most of the container with protein and you will need to eat that first in your meal. That's why we have those rules.

Later on when you can eat more, you will still need roughly the same amount of protein. But you will have more extra space for other food. That's when you get to make the choice about how much space you give to extra protein, fat, or carbs. Within the carb section, you will choose how much is available for vegetables, how much for fruit, how much for starchy foods, and hie much for sweets.

All those choices you make will affect the calories of the meal you are fitting into the limited volume of your sleeve or pouch.