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I'm in the process of figuring this out. I'm 4 weeks post plastics (yay!) so I am not "exercising" yet.

Prior to plastics consult I was eating 1800-2000 calories a day and still losing weight.

So once I'm back to life, I will be trying to find the sweet spot between exercise and calories to maintain my weight. I have a balanced and reasonable approach to "exercise". Approved by all my doctors. I just have to really work on eating a lot and I don't like to be food focused. I don't like ice cream much anymore. I do eat highly nutritious foods like previously mentioned.

For example I might eat half a banana smeared with Peanut Butter. Beans and cheese and avocado is a staple. Pre sleeve just thinking about that would've been a five pound gain penalty. I do work with an endocrinologist who specializes in bariatric patients but I'm over due for an appointment. I'll go see him once I'm back to "normal".

I hope you get answers quickly. I'm glad you're

seeing physicians.

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I'm in the process of figuring this out. I'm 4 weeks post plastics (yay!) so I am not "exercising" yet. Prior to plastics consult I was eating 1800-2000 calories a day and still losing weight. So once I'm back to life, I will be trying to find the sweet spot between exercise and calories to maintain my weight. I have a balanced and reasonable approach to "exercise". Approved by all my doctors. I just have to really work on eating a lot and I don't like to be food focused. I don't like ice cream much anymore. I do eat highly nutritious foods like previously mentioned. For example I might eat half a banana smeared with Peanut Butter. Beans and cheese and avocado is a staple. Pre sleeve just thinking about that would've been a five pound gain penalty. I do work with an endocrinologist who specializes in bariatric patients but I'm over due for an appointment. I'll go see him once I'm back to "normal". I hope you get answers quickly. I'm glad you're seeing physicians.

CBT, it's good to see you in this thread! There are too few of us with this issue represented on this site. I really feel this is more common than folks realize... but that those of us who are dealing with this are not as likely to come to the site.

I've had some statements that I should exercise less. Given that my doc feels that my exercise is totally appropriate - actually, my primary doc and my bariatric doc both - I would say I am on the right track! Yet, for those who are not fighting the same issue with keeping up sufficient weight, I suppose it does seem like an easy enough solution - it's just that I didn't make the change to be thin and sedentary! I made the change to be athletic. Trim is helpful, athletic - athletic is awesome. The OP seems to have had similar sentiments thrown her way. I understand the reticence to give up exercise. It does force you to bring up the calories to match your body's requirements if you want to improve, though.

Also, I have found that nutritionists don't have a lot of experience with this issue. I have recently found a helpful and more nutritious way to up calories. It isn't cheap, though. I have been juicing. I am mixing fruits and veggies, with a slightly higher proportion of fruits to keep up the calorie count. As it is a liquid I have almost no restriction (I do have to drink more slowly than water) and am able to get far more nutrients and calories than I would otherwise. Now that I have dropped to 120, I am feeling like I absolutely have to make myself get more calories in. So... juicing. I think it is a good recommendation for the OP. Ice cream is good - but if you feel like it isn't a great answer for you, juicing tastes far cleaner and healthier. By adding kale, cucumber, and lime when you make it, the sweetness is balanced out and it tastes pretty good, too!

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That's a good idea, I'm sure I can add in a Protien smoothie a day. Saw my new doc and nutritionist last week, they where both unhappy with my weight, said I need to gain, but didn't really give me advice on how to. The doc told me to stop working out which is dumb in my opinion. I just worked hard the last year to change my life style and don't want to through it all away. If did switch it up so now I'm doing more strength work and less cardio every week.

i am not a vet, so dont know if i can post here or not, but i want to say that slowing down your exercising isnt throwing anything away! not by a long shot. moderating both your exercising (doing less) and your food intake (by eating more) should help you to stop losing weight. you arent loosing one iota of anything by learning to adjust based on your current circumstances.

its important that you track both so you know how to adjust. we are all here because we have a disordered relationship with food. this can swing in the opposite direction at anytime. so remain mindful of how you are coping with your stress. if you feel everything in your life is out of control and one thing you can control is eating and exercise... you might take that too far to cope. its the flip side of the coin from coping with your stress by eating. you may want to find a therapist who specializes in eating disorders who can help you find healthy ways to cope with stress and feelings of loss of control. good luck!

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what about drinking ensure 2x a week I had a friend (who not sleeved) but lost a lot of weight and she drank that with icecream mixed in..but not sure If you can have icecream

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One of the issues post plastics is that the compression garments sqeeze your tummy and people can't eat as much at once. I was hungry ALOT so I ate more frequent tiny meals and had a lot of Protein drinks. Alot of people go into mega burn post plastics too which I must have since I didn't gain weight and I ate CONSTANTLY I was so hungry.

I guess I am one of those people who will never have problems with anerexia or losing too much weight or anything like that. My body gets to feeling a little under-plenished and I get HUNGRY.

Once I got to my initial goal of 158 I maintained there for 6 months before dropping another 10. i am maintaining in the range of 146-152 these days just as easily as I maintained 158 but I think that it helped that I took a little break from losing. My body has a real survival gene I guess - it lets me know when the calorie bank is running low. I really wonder and find it puzzling in many ways that people who had such a high burn pre-op or for whatever reason find that they can't stop losing now.

I am very supportive - don't get me wrong - I have a close friend who works so hard to keep weight on (he is older and naturally skinny and drops weight when anything bad happens) I get it that it is a very serious problem. It is just so foreign to me that it is hard to even understand it.

I hope that people who do struggle with this realize that we do SUPPORT you because we all have some sort of issue with food and weight and what we all want is a healthy, comfortable relationship with food and weight. I just don't always understand it.

I do however know how I gain weight... carbs are the secret to my weight gaining success. :) Not only do carbs tend to make me gain weight, they also make me hungry so I can keep gaining. It's great to know I have a good backup plan should I ever get too thin. (crackers, Peanut Butter, high carb Protein Bars, sweet fruit especially juices - doesn't even need to be unhealthy carbs, any will do!)

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One of the issues post plastics is that the compression garments sqeeze your tummy and people can't eat as much at once. I was hungry ALOT so I ate more frequent tiny meals and had a lot of Protein drinks. Alot of people go into mega burn post plastics too which I must have since I didn't gain weight and I ate CONSTANTLY I was so hungry. I guess I am one of those people who will never have problems with anerexia or losing too much weight or anything like that. My body gets to feeling a little under-plenished and I get HUNGRY. Once I got to my initial goal of 158 I maintained there for 6 months before dropping another 10. i am maintaining in the range of 146-152 these days just as easily as I maintained 158 but I think that it helped that I took a little break from losing. My body has a real survival gene I guess - it lets me know when the calorie bank is running low. I really wonder and find it puzzling in many ways that people who had such a high burn pre-op or for whatever reason find that they can't stop losing now. I am very supportive - don't get me wrong - I have a close friend who works so hard to keep weight on (he is older and naturally skinny and drops weight when anything bad happens) I get it that it is a very serious problem. It is just so foreign to me that it is hard to even understand it. I hope that people who do struggle with this realize that we do SUPPORT you because we all have some sort of issue with food and weight and what we all want is a healthy, comfortable relationship with food and weight. I just don't always understand it. I do however know how I gain weight... carbs are the secret to my weight gaining success. :) Not only do carbs tend to make me gain weight, they also make me hungry so I can keep gaining. It's great to know I have a good backup plan should I ever get too thin. (crackers, Peanut Butter, high carb Protein Bars, sweet fruit especially juices - doesn't even need to be unhealthy carbs, any will do!)

So - what I was told is that I likely a medical condition that has made me overly hungry - probably involving leptin rather than grehlin. I haven't been able to afford the testing, it is not covered by my inadequate insurance. The specialist I saw thinks this explains why after the surgery I never had a decrease in my hunger - none, whatsoever. The doc thinks that reducing grehlin didn't help me because I have too much leptin. I was more than adequately treated with PPI's for acid reflux etc.

Anyway - my obesity was due to regular and continuous overeating. I was hungry every few hours, no matter what I ate. That remains true. The difference is twofold: 1) my metabolism has improved because I am far more active 2) I don't have enough capacity to meet my caloric needs, especially if I get busy and miss an opportunity for a meal or snack - there isn't a way to make up for that easily. Currently, I have an added issue that my stomach has tightened up severely with stress and so my capacity is way down.

I am drinking a lot of fruit juice, ensure, Protein Drinks, and soft foods seem to be working better like cheese grits, pastries, chocolate, etc. I just go for any high calorie food that my stomach will tolerate. I gravitate towards lots and lots of carbs and fats, as I can physically fit more into my sleeve. I aim for enough Protein to maintain muscle. Also, the caloric fruit juices. My weight has just recently stabilized and I have put a pound back on, which is moving back in the right direction.

I did once accidentally gain weight after surgery - not just a normal fluctuation or muscle gain, but fat. And it was when I drank 3-4 8oz glasses of fresh orange juice every day for 10 days, combined with eating out for every meal and not exercising at all. I think I gained about 3-4 lbs. So, it's not impossible for me to gain weight. It is just really unlikely in my normal lifestyle.

But... that should explain, in a nutshell, how someone who was obese can end up with this problem. There are plenty of medical issues that can lead to obesity and aren't very well understood. Bariatric surgeons are not very good at diagnosing or recognizing these issues as it is not their area of expertise - not really. They treat obesity thru surgery, and that is usually their focus.

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Just wanted to add in an update, I have finally started not just maintaining but actually very slowly gaining some weight back which I am very happy about. I HAVE to continually keep a food journal and have to have at least 2 smoothies a or Protien shakes a day to keep my calories high enough to maintain and 3-4 a day to gain. I've learned how May calories my body has to have to maintain and gain. I would like to address the few negative comments and messages I recieved mostly about working out. When I lost weight it was not to feel better about myself it was to regain an active lifestyle that I was so badly missing overweight and so for me working out is a very important thing it's one of the main reason I had this surgery. I understand that everyone does this for there own reasons but that was an important one for me. For those of you who told me I just needed to stop working out and argued that I was continuing to do it for "control" issues you are incorrect, working out for me is a tremendous stress relief and I did have to modify my cardio and add in more strength training. I want to enjoy my new healthier body by getting out and using it, working out, going hiking, mountain climbing, riding bikes, running at the beach. I did have to learn how to have this lifestyle manage stress and figure out exactly how much calories/Protien my body needs. For the naysayers this does not mean I need counseling or have a problem and for those of you that have the opposite problem and messaged me because you where angry that I was "complaining" about losing weight I was not complaining I was reaching out for advice. I am sorry that some of you are not having the results you wanted and I hope that you are able to get the support you need and figure out what will work for YOUR specific body and lifestyle.

Good luck to everyone on this journey and thank you so much to everyone who offered support and positive advice and encouraging words I so appricate you.

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Tara -

Congratulations on your success regaining scale stability! I am in the same boat. I hit my goal very fast and just sorta thought "this is easy". Then I shot past my goal and, fearful of falling back into bad eating habits, I didnt want to add back in the fats and carbs. I guess you have to.

I'm trying to climb back to 220 and it's hard. My joints are starting to stick out and my clavicle/shoulder blades look bony. EW! I'm not shallow but skeletons belong in the closet!

I love the ideas in this thread so much I thought it would be good to collect them in an easily searchable library. I put it under nutrition and called it "maintenance menu". Everyone please share your vet knowledge over there as I am sure there are dozens of people searching who share our same problem.

http://www.bariatricpal.com/topic/313765-maintenance-menu-adding-calories-responsibly/

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I am 30 pounds below my goal weight. At 195 and six four I am super thin. My wife has been asking me to stop losing and I finally called my nutritionist and asked her for help. I was told to introduce healthy fats into my diet, like avacado and olive oil and the like. I also upped my carb intake slightly and I thought I was doing better but I have lost another five pounds this last week. I just keep trying to add a few calories when I can but lately I get full pretty fast. I do at least 2 Protein bars a day and a Protein shake every morning still.

Good luck, who woulda thunk we would have a underweight issue huh?

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Not trying to give you unhealthy advice but I tell you that coffee frappes and ice cream will put it on you. Seriously, I know it is a problem for you. I'm having issues because I don't eat AT ALL. No food, just liquid calories and my blood work shows my metabolism is almost no existent. Since my husband died, all I do is drink sugar. Not soda. Caffeine and sugar. It has put 23 pounds on me since January and I'm very unhealthy. You could try Boost or Ensure and drink while you are just busy doing everyday things. That should help. I'm hoping to get my wits back about me and get this weight back off. I'm so depressed because I can't get into my clothes I purchased. I feel like a failure again. So hard fighting this "weight" thing.

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I had the same problem of losing. Dr set my weight at 130, I wanted some wiggle room so wanted 125. Got down to 120.2. Nut said to add nuts, Peanut Butter and fruits as well as start tracking my food again. If I hit 124 I start really watching what I am eating. I am 67 now and 21 months out. Good luck to you. I still have to supplement with Protein Shakes and or bar to get in enough Protein.< /p>

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Just wanted to add in an update, I have finally started not just maintaining but actually very slowly gaining some weight back which I am very happy about. I HAVE to continually keep a food journal and have to have at least 2 smoothies a or Protien shakes a day to keep my calories high enough to maintain and 3-4 a day to gain. I've learned how May calories my body has to have to maintain and gain. I would like to address the few negative comments and messages I recieved mostly about working out. When I lost weight it was not to feel better about myself it was to regain an active lifestyle that I was so badly missing overweight and so for me working out is a very important thing it's one of the main reason I had this surgery. I understand that everyone does this for there own reasons but that was an important one for me. For those of you who told me I just needed to stop working out and argued that I was continuing to do it for "control" issues you are incorrect, working out for me is a tremendous stress relief and I did have to modify my cardio and add in more strength training. I want to enjoy my new healthier body by getting out and using it, working out, going hiking, mountain climbing, riding bikes, running at the beach. I did have to learn how to have this lifestyle manage stress and figure out exactly how much calories/Protien my body needs. For the naysayers this does not mean I need counseling or have a problem and for those of you that have the opposite problem and messaged me because you where angry that I was "complaining" about losing weight I was not complaining I was reaching out for advice. I am sorry that some of you are not having the results you wanted and I hope that you are able to get the support you need and figure out what will work for YOUR specific body and lifestyle.

Good luck to everyone on this journey and thank you so much to everyone who offered support and positive advice and encouraging words I so appricate you.

Thanks for the update! I'm currently going through unwanted weight loss myself. Never thought this would happen to me. My goal weight was 140, when I reached it, I was happy and satisfied. I even started to allow myself a bit more (as far as Snacks, I'd start to eat a bit of popcorn here and there, I'd allow myself a piece of chocolate, etc). But despite that, I am now at 125 and going down. I'm 5'5", and I am what you would call "big boned". So at 125, though I am a size 6, it's just because the pants hug my hip bones, which can't get any smaller. I'm literally TOO SKINNY. :-( I guess I will start adding more liquid calories, ensures and things...

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I am too skinny too and I have also surpassed my goal weight. I am a size 4 and am trying to gain a few pounds, but I just can't eat that much still so I'm losing too much. I'm 6 months out. I'm hoping after a year it will get better.

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I am in the same boat. My nutritionist asked me to increase my amounts of "healthy fats". Like olive oil, avacado and things like that into my daily diet. I have also added a couple of small Snacks to my daily food intake. I know its hard to do but a half an apple or orange or even 3 or 4 crackers with Peanut Butter will help. I am 35 pounds below my goal weight my self. I still lost two more pounds this week.

Good luck, Mark

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