I am becoming a bit disenchanted with my WLS clinic. I'm losing at a decent rate (down 35 pounds since surgery 7 weeks ago). What I am not happy about is my clinic's mandate that I follow a diet that has me eating no more than 15g of carbs a day, less than 500 calories a day. Plus, this diet should be in place until I lose 75% of my excess weight loss (which, for me, is 100 pounds - or 65 now)

I met with the dietician yesterday and came out of the meeting very frustrated. She didn't like the fact that I ate a yogurt that has 80 calories, 0g fat, and 12g of Protein - why? It has 8 carbs. "You shouldn't be eating more than 5 carbs per meal" was her reply. Mind you, when I eat that yogurt I'm not going over 15 for the day - but no, it's not good because it's more than 5 carbs for the meal. And it's because I'm going over 5 carbs a meal that my weight loss isn't as fast as other people's.

I also mentioned that I'm a little tired of depending on Miralax on a weekly/biweekly basis and that I was concerned my constipation is being caused by a lack of Fiber. She said no, it's not a lack of fiber and that I just need to up my Water intake. Um, I'm already getting between 64-80 a day! And to say fiber isn't an issue is utter BS in my opinion.

It's not just the NUT who says this - it's in the clinic's aftercare manual. I am really tempted to find some other doctor/clinic's aftercare suggestions and follow those for a bit and see what happens.

Edited February 14, 201412 yr by Mel1071

No dairy? Osteoporosis. Teeth dissolving. Vertebrae crumbling.

the only thing my surgeons NUT told us to always pair any carb we eat with a Protein. They said always eat protein first. They did not give us any rules amount amount of carbs. As far as the miralax, I am familiar with that but I am big on plant Proteins. I also add chia seeds and flax to anything I can.

So strange how each of us has our own guidelines. Any protein powders I'm to consume (and your product would still be considered protein powder) is to have less than 5g carbs. And grams of carbs should never exceed grams of protein.

Seems difficult, but I'm finding that it really isn't. They are a center of excellence and respect the facility a lot, as I'm certain you respect yours.

There are lots of constipation remedies. From powders, to laxatives and suppositories, to stool softeners and enemas. Now as for the OP to remain at 500 calories per day until 100 pounds is lost, that is mystifying me.

My nut said the goal for optimum weight loss is about double that, if I'm too low for very long I'll go into starvation mode and stop losing. When I work out I will need efficient energy to sustain a workout. This is one reason they only have you walk for the first 6 weeks. So you have time to bump your caloric intake.

I add Fiber One (the original Cereal that looks like fish food stix). I use about 2 tbs and this works for me to stay regular. Since a serving has 14 gm of fiber (in 1/2 cup) I figure I get about 7 gm of fiber, plus the cereal has added Vitamins and minerals (which I am always trying to get in my diet in hopes to get off all the pills)

So strange how each of us has our own guidelines. Any Protein powders I'm to consume (and your product would still be considered protein powder) is to have less than 5g carbs. And grams of carbs should never exceed grams of protein.

Seems difficult, but I'm finding that it really isn't. They are a center of excellence and respect the facility a lot, as I'm certain you respect yours.

There are lots of constipation remedies. From powders, to laxatives and suppositories, to stool softeners and enemas. Now as for the OP to remain at 500 calories per day until 100 pounds is lost, that is mystifying me.

My nut said the goal for optimum weight loss is about double that, if I'm too low for very long I'll go into starvation mode and stop losing. When I work out I will need efficient energy to sustain a workout. This is one reason they only have you walk for the first 6 weeks. So you have time to bump your caloric intake.

OMG.. I love that Hemp powder and b/c it is so high in fiber is negates some of the carbs. I definitely will limit eating carbs but I don't think I want to count grams. I already have to count protein and Water intake. I think if I just stay away from carbs in general.. whatever carbs are in the meals I eat which are rich and protein and high in fiber I will be good. It does amaze me how different each surgeon is too!! I am going to ask about the carb intake at my 5 week follow up visit. Maybe I missed something at the nutrition class. Thanks for the feedback.

So strange how each of us has our own guidelines. Any Protein powders I'm to consume (and your product would still be considered protein powder) is to have less than 5g carbs. And grams of carbs should never exceed grams of protein.

Seems difficult, but I'm finding that it really isn't. They are a center of excellence and respect the facility a lot, as I'm certain you respect yours.

There are lots of constipation remedies. From powders, to laxatives and suppositories, to stool softeners and enemas. Now as for the OP to remain at 500 calories per day until 100 pounds is lost, that is mystifying me.

My nut said the goal for optimum weight loss is about double that, if I'm too low for very long I'll go into starvation mode and stop losing. When I work out I will need efficient energy to sustain a workout. This is one reason they only have you walk for the first 6 weeks. So you have time to bump your caloric intake.

OMG.. I love that Hemp powder and b/c it is so high in Fiber is negates some of the carbs. I definitely will limit eating carbs but I don't think I want to count grams. I already have to count protein and Water intake. I think if I just stay away from carbs in general.. whatever carbs are in the meals I eat which are rich and protein and high in fiber I will be good. It does amaze me how different each surgeon is too!! I am going to ask about the carb intake at my 5 week follow up visit. Maybe I missed something at the nutrition class. Thanks for the feedback.

Okay.. I went to dig out my written materials from nutrition class. This is what they gave us as the 'general guidelines after weight loss surgery'

Less than one month post op (where I am)

Fluid: 48-64oz

Calories: Minimum of 800 kcal (although they did say it may be difficult at first for obvious reasons)

Protein: 60-80g

Carbs: 90-100g

Fat: 18-22g

Fiber: Less than 20g

1-6 months post op

Fluid: 48-64oz

Calories: About 1200

Protein: 80g-100g

Carbs: 135g-150g

Fat: 27g-33g

Fiber: 20g-25g

More than 6 months post op

Fluid: 48-64oz

Calories: Dependent on individual needs

Protein: 30-35% of total kcal ex. 1200 kcal diet = 105g protein

Carbs: 40-50% of total kcal

Fat: 20-25% of total kcal

Fiber: Less than age 50 = 25g for women 38g for men. Age over 50 = 14g per 1000 kcal

I am becoming a bit disenchanted with my WLS clinic. I'm losing at a decent rate (down 35 pounds since surgery 7 weeks ago). What I am not happy about is my clinic's mandate that I follow a diet that has me eating no more than 15g of carbs a day, less than 500 calories a day. Plus, this diet should be in place until I lose 75% of my excess weight loss (which, for me, is 100 pounds - or 65 now)

I met with the dietician yesterday and came out of the meeting very frustrated. She didn't like the fact that I ate a yogurt that has 80 calories, 0g fat, and 12g of Protein - why? It has 8 carbs. "You shouldn't be eating more than 5 carbs per meal" was her reply. Mind you, when I eat that yogurt I'm not going over 15 for the day - but no, it's not good because it's more than 5 carbs for the meal. And it's because I'm going over 5 carbs a meal that my weight loss isn't as fast as other people's.

I also mentioned that I'm a little tired of depending on Miralax on a weekly/biweekly basis and that I was concerned my constipation is being caused by a lack of fiber. She said no, it's not a lack of fiber and that I just need to up my Water intake. Um, I'm already getting between 64-80 a day! And to say fiber isn't an issue is utter BS in my opinion.

It's not just the NUT who says this - it's in the clinic's aftercare manual. I am really tempted to find some other doctor/clinic's aftercare suggestions and follow those for a bit and see what happens.

I started a new thread to see what other members doc's are recommending just b/c there are soooooo many variances from doctor to doctor. I had to dig out my pre op nutrition class materials but I posted what my surgeon post op recommendations are and they are sooooo drastically different than yours. It's like... how can that be? I mean.. shouldn't this be kind of standard. I am so confused!

Okay.. I went to dig out my written materials from nutrition class. This is what they gave us as the 'general guidelines after weight loss surgery' Less than one month post op (where I am) Fluid: 48-64oz Calories: Minimum of 800 kcal (although they did say it may be difficult at first for obvious reasons) Protein: 60-80g Carbs: 90-100g Fat: 18-22g Fiber: Less than 20g 1-6 months post op Fluid: 48-64oz Calories: About 1200 Protein: 80g-100g Carbs: 135g-150g Fat: 27g-33g Fiber: 20g-25g More than 6 months post op Fluid: 48-64oz Calories: Dependent on individual needs Protein: 30-35% of total kcal ex. 1200 kcal diet = 105g Protein Carbs: 40-50% of total kcal Fat: 20-25% of total kcal Fiber: Less than age 50 = 25g for women 38g for men. Age over 50 = 14g per 1000 kcal

Wowza! Yours is totally different from mine. Totally. I'm not to have over 50g carbs a day til I reach goal. My protein is at least 70g.

The carbs I get are to come from vegetables and fruits with the exception of sf pudding ( only if I add Protein Powder to it) and ff yogurts which I am to have at least 12g protein in.

I believe what you are seeing is a changing of the philosophy from high carbs are good for you to carbs are non-essential. Yes, this means Atkins was right all along and the entire medical establishment was wrong. So you see old information mixed with new information out there.

Also, the one size fits all on calories and Protein is just plain wrong. If one person has 200lb lean body mass and another female has 120lb lean body mass why is the protein intake the same recommendation in order to preserve lean body mass? This is highly flawed.

If you eat 3(-4oz @2+ months) protein first there will likely not be much room for anything else. Carbohydrates are not necessary for the human body. Water, protein, micronutrients and fat are daily requirements.

The latest and greatest best studies pretty much backup for best fat loss (not just weight loss) low carb is the optimal way to lose the fat. It is funny to me to watch the transition in the minds of the medical community - people sure do resist change even in the face of very compelling evidence.

All of us has to find what works best for all of us individually. Ideally you get your body fat measured and use that as your guide to weight loss. Losing lean body mass, organs, bones is NOT healthy. Nutritionists are just parrots. They seldom are able to do research and really think for themselves. Whatever the latest medical dogma is will be what they tell you. Therefore, do your own research and do your own experiment on yourself carefully. It is your life, your health.

I started a new thread to see what other members doc's are recommending just b/c there are soooooo many variances from doctor to doctor. I had to dig out my pre op nutrition class materials but I posted what my surgeon post op recommendations are and they are sooooo drastically different than yours. It's like... how can that be? I mean.. shouldn't this be kind of standard. I am so confused!

I am becoming a bit disenchanted with my WLS clinic. I'm losing at a decent rate (down 35 pounds since surgery 7 weeks ago). What I am not happy about is my clinic's mandate that I follow a diet that has me eating no more than 15g of carbs a day, less than 500 calories a day. Plus, this diet should be in place until I lose 75% of my excess weight loss (which, for me, is 100 pounds - or 65 now)

I met with the dietician yesterday and came out of the meeting very frustrated. She didn't like the fact that I ate a yogurt that has 80 calories, 0g fat, and 12g of protein - why? It has 8 carbs. "You shouldn't be eating more than 5 carbs per meal" was her reply. Mind you, when I eat that yogurt I'm not going over 15 for the day - but no, it's not good because it's more than 5 carbs for the meal. And it's because I'm going over 5 carbs a meal that my weight loss isn't as fast as other people's.

I also mentioned that I'm a little tired of depending on Miralax on a weekly/biweekly basis and that I was concerned my constipation is being caused by a lack of fiber. She said no, it's not a lack of fiber and that I just need to up my water intake. Um, I'm already getting between 64-80 a day! And to say fiber isn't an issue is utter BS in my opinion.

It's not just the NUT who says this - it's in the clinic's aftercare manual. I am really tempted to find some other doctor/clinic's aftercare suggestions and follow those for a bit and see what happens.

Thank you all so much for your input! I appreciate you all very much. The doctor's office is always saying if you are having issues, contact the dietician - they are here to help you succeed. But anyone who is going to lecture me about eating an 8 gr of carb yogurt because it exceeds 5 gr and also tell me fiber isn't going to help my constipation issues just isn't high on my list of trusted sources I mean, it's not like I was asking to eat a bunch of simple carbs - I just want to boost my complex carbs in hopes of getting that fiber in.

As I'm getting in plenty of Water and Protein my main goal now is to up my activity. And if doing that means I need to up my carbs/calories, then so be it. Because one of my main goals of having this surgery was to get to the point where I'm more active and able to do more things with my husband. I think I may have a cathartic burning of my aftercare manual lol

Thanks again!

My office basically said so whatever works for you right now... Try different foods and see how you feel. I like that.

My office basically said so whatever works for you right now... Try different foods and see how you feel. I like that.

Love the new pic!!!!

Yes, find a clinic that supports you. This place is abusive!

I would check for another weight loss center/ team.

Ive been advised to switch out milk for 1:3 cream:water. No carbs.

HTH

I can tell you I couldn't function on what you're allowed.

I restricted my carbs in the beginning - on my own, not dictated by my doc/nut. I felt like crap. I had no energy. Then I started exercising and it got worse. I was down in the 20 range for carbs at that point. I burn between 500-700 calories in a 60 minute cardio work out, depending on what I'm doing.

After going to my doc and explaining my situation I let her know I increased my carbs to about 50-60 and she agreed that would be good and to concentrate on the Protein. She asked how I'm getting in more carbs - I told her I was adding low-glycemic fruit to my shakes (berries or peaches) or I added 1-2 tablespoons of fat-free refried Beans to a meal and I started adding 1% milk to my shakes. She said these were great ideas.

Right now, I'm taking in 800-1000 calories per day. I'm getting about 50-60 carbs per day and meeting my protein gold of 80 grams of protein. I exercise 5-6 days per week - mostly cardio right now, 60-75 minutes. I have lots of energy and I feel great.

My suggestion would be to go to another bariatric nutritionist to get a 2nd opinion. I think the theories here are correct - you need more. 500 calories is not enough to sustain you.