Hi,

I had my bypass on April 2nd of this year. I'm at that point where I'm still physically not hungry but "I could eat"...

I have a couple of questions that I could really use some input on...

1. Eating just because I'm told I have to, not because I'm hungry.
   
   Had my followup with the Nutritionist and -- being the data geek that I am -- showed her all sorts of charts from MFP as to calories, She is all over my butt saying "you MUST eat three meals a day, plus your two shakes". I've been doing that anyway, but it's NEVER because I'm physically hungry. Just because she keeps kicking that dead horse.
   
   I'm now up to an average between 1000 and 1300 calories a day, sometimes whether I feel or need them or not. (360 to 400 for the shakes, 500-900 for food) It has become a "habit" to eat something and not a "need"..
   
   The problem in my mind is that since going from Fluid to mushy to regular (officially cleared), my weight loss has gone from 1-3 pounds a day, to 2-3 pounds a week, to pretty much 1-3 pounds every 7 to 11 days...
   
   I "get" the need for the shakes, and I'm doing my best there despite the fact that I'm completely burned out on them, but am I supposed to be eating something when I'm not hungry JUST because it's on some checklist of stuff that the average post-op is supposed to do? It seems entirely counterintuitive.
   
   I feel like I'm getting crappy guidance, but there may be a real reason for it. I dunno.
   
2. Calorie / other counts after surgery....
   
   Again, being the data geek that I am, I go by statistics and charts to tell what I'm doing (right or wrong). During my followup, I asked my nutritionist DIRECTLY "How many calories, how much sodium, etcetera am I supposed to be getting?".
   
   Her reply -- which really burns my butt -- was "I'm really not worried about calories or that other stuff right now. I'm just focusing on you getting your protein"... A complete evasion and non-answer which I find useless and non-helpful.
   
   At 6'3" and now 245 pounds (down from 300 when I started the surgery route in October), how do I figure out how much *I* need to consume in order to make sure I can get to my 200/210 goal? MFP doesn't account for WLS, so I'm completely in the dark here.
   
   The average I'm consuming now, let's say an average 1200 calories, has me stalled at 245 and getting frustrated when I was told by the doctor that I could realistically expect 210/220 pounds...

Thanks for any help you might be able to provide. If I'm just being silly, that's ok too, but "be gentle" about telling me that I'm an idiot..

Wayne

All the nutritionists say that same thing. Personally, I don't find them very helpful. Mostly because I want to know WHY a lot of times. Or I need help and they just say--"you're doing great." But I don't know what it is that is great especially when I feel like I'm floundering.

Anyway, don't get hung up on data. If you wait to eat until you are hungry, you might overeat. You should eat Protein every couple of hours. Which basically is Breakfast, lunch, dinner and Snacks. Maybe if you just ate smaller portions during those meals? You said you aren't hungry anyway. And eating every few hours keeps you from getting hungry. My nutritionist had me stop doing the shakes when I went on solid food. Every once in a while I'll add them back in but I found that I am eating enough protein that I don't need them. I try to have yogurt or cottage cheese as my snack instead of the shakes. If I know I will have a hard time getting enough protein in, I drink the Isopure Protein Drink which is an acquired taste (and I now really like them) but is better than the shakes.

Also, the fact that your weight loss is less, is normal. Losing a few pounds a week is pretty normal from what I hear. The more you exercise, the more you can lose each week.

So, as much as it pains me to say it, focus on getting in your protein and get lot's of exercise. I know that they have me starting to watch the grams of sugar in food now but they have never mentioned sodium. I just try to keep it low by eating protein, veg, and fruit with some carbs. Those don't have sodium so you naturally keep it at bay.

I don't think I'm helping you but I'm definitely helping me by writing this! I need it reinforced!

Best of luck.

All the nutritionists say that same thing. Personally, I don't find them very helpful. Mostly because I want to know WHY a lot of times. Or I need help and they just say--"you're doing great." But I don't know what it is that is great especially when I feel like I'm floundering.

Therein lies a lot of my frustration. The "bottled, canned" answers. I understand that since surgery I've gone from a "freefall" to a "slide" to a "stairstep" situation with weight loss and according to friends, that's normal, but to me, it feels like I'm doing something wrong.

When I go from daily to weekly weigh-ins and I see no change, I can only imagine that I must be doing something wrong (assuming the scale isn't broken )... At this point -- though I accept my silly premise -- I *feel* like I was doing better on Weight Watchers...

For the record though, my body adapted and rejected Weight Watchers at 249 pounds, so the fact that I'm below that is a good thing. The fact that I'm now seemingly stuck so close to that weight is the scary "is it happening again?!" part.

Also for the record, your reply WAS helpful and affirming, so I greatly appreciate it. I just want to be my promised 210/220 NOW..

Wayne

Here is my 2 cents on this. You must eat. If you are not hungry you still need to eat. This is a tool and they work when you listen and do what you are susposed to. Eat every couple of hours. Your stomach can only hold about 3 ounces at a time so little amounts here and there are best. If you don't eat then you don't process nutrients and the body takes from your resources ie Calcium from your bones, etc so it gets what it needs when it wants it. Spice up your shakes with sugar free syrups-that what I do to change out the flavors. I ordered 8 flavors from Torani and depending on my mood depends on the flavor of the time. Easy and different. This is a new lifestyle for you and not really a diet per se so the NUTs don't stress calories as much as they state Protein first, veggies next and if room then carbs. Stick to that and you won't over eat. This is how you help your tool. Analize your exercise routine and make charts and send them to me to get me on an exercise kick. i could use the help!

I know someone who did not eat because she was not hungry and she felt nauseous. She ended up in the e/r thinking she was dehydrated but instead was told she was malnurished. Don't rock the system-it works and let it work for you! She was yelled at and told she almost killed herself. Yikes! Hang in there Wayne!

Hi Wayne,

I thought I would add in what I have learned in this journey, although you have already received some pretty good advice. Every clinic is different on recommendations at the beginning, but most that I have seen really do focus on getting Water and Protein in for at least the first three months. Calories, fat, sodium, carbs, really don't mean much, because we simply are not eating much of them. Most WLS a patients will not really begin to feel hunger until sometime around eight months post surgery. The nerves that send the message to the brain normally are fully healed about that time and begin working again. This is an average, some feel actual physical hunger sooner, some later. This is why they do not recommend that you wait to feel hungry to eat. You want to keep your blood sugars steady, and the best way to do that is to eat at regular times throughout the day. Because the volume of food that we can ingest is so small, the real only good way to reach protein goals is to have the shakes, although my clinic was fine with one Premier Protein shake a day - they have 30 grams of protein.

I use MFP to track everything I eat - still. In the beginning my calories were around 300 per day, with exercise I was normally in the negative at the end of the day. Even a year out, I still have days that my calories intake minus exercise puts me in the negative. I am very healthy and feel great, so this is not a bad thing!

Your clinic staff really are your best experts. Some of the advice goes against what we have been taught about eating for weight loss over the years, but it really does work in a WLS patient. I have followed the plan as closely as possible and my success has been beyond anything that I ever imagined. Feel free to ask questions! That is how we learn! I am willing to help in any way that I can.

Carol

Wayne, I'm with you on the data thing. I'm a statistician so I want to know all the numbers and see the charts and KNOW that I'm doing what I'm supposed to do. It even irritates me that on My Fitness Pal, I can't just put in 60 grams of Protein as a goal, I have to make it a percent of some total calories for the day. IRRITATED!!!

I get the same answers you do about "focus on protein" and not much else. But, I'm only 10 days out from surgery, and just getting the protein requires enough thought process I don't have room for all the other stuff yet.

I wish I could offer some great advice or something but I think for us number geeks, we're going to have to just relax a little and get over it!

Ginger

Maybe we need to develop our own mobile app for our needs! One that can guide you from pre-surgery through post surgery and maintenance. Anyone? I could help!

I'm currently pre op, surgery on the 8th of July, someone mentioned to me once upon a time to calculate my BMR. I've always heard of bmi, but not bmr- which tells you how many calories your body burns per day and can be adjusted depending on how much weight you need to lose. Not sure if this applies to bariatric patients or not, but might also be a helpful tool. http://www.bmi-calculator.net/bmr-calculator/

I am 5 months post op gastric bypass. I still do not get hungry. I am learning the new feeling of full but still mostly go by how much food I eat. You just have to be sure you eat regularly.

Am I the only person who still gets hungry? I hate getting hungry but I do. Luckily it doesn't take much to be satisfied but it sure surprised me since I heard this removes the hunger hormone. Guess they cut around it instead! lol

I am 9.5 weeks post op with no hunger. When the 5 hour timer goes off, I eat. 3 times a day. No Snacks. No shakes or supplements.

My NUT said not to track calories. Work on Protein every meal. 2 oz protein, 2 ounces fruit or veggies. Sometimes I get that all down, sometimes I'm too full.

Am I the only person who still gets hungry? I hate getting hungry but I do. Luckily it doesn't take much to be satisfied but it sure surprised me since I heard this removes the hunger hormone. Guess they cut around it instead! lol

13 weeks out and I can safely say that you're not the only one. I do get hungry. Most of it is in my mind and enforced by the "you must stick to a strict eating schedule" mentality of my nutritionist, but some days I eat way more than I should, others -- like this weekend -- I find myself not eating at all because I'm just not hungry..

I think my cravings are more about getting the flavors than wanting to eat an entire course. For example, I'll go to my favorite local seafood place and order the smoked salmon knowing that I'll end up making three or four meals out of it.

I get the taste, I get 3-4 meals. All is good.

The one thing that this surgery has given me is a non-negotiable tool. Eating badly now has dreadful (and yucky) consequences which usually involve prayer to the porcelain God Ralph... In essence, surgery to me is about like the equivalent of a dog wearing a bark collar. Bark? Zap. (Overeat? Barf.) That's what I need to train myself to eat well...

Wayne

Am I the only person who still gets hungry? I hate getting hungry but I do. Luckily it doesn't take much to be satisfied but it sure surprised me since I heard this removes the hunger hormone. Guess they cut around it instead! lol

I get hungry too. It's not quite the same feeling of hunger as I got before, but I get it. My tummy definitely lets me know when I should eat.

I am also not hungry 4 months out. I am taking advantage of this time to reset the way I view food since I am not a slave to my hunger right now. I eat to survive, not because I am hungry and try hard to stay on my every 3 hour eating schedule. There are times when I can't eat all of my 4 oz meal, but I don't fret. I supplement with Protein shakes on those days to keep my protein intake at least 80 grams/day. That way, I hope that I will be less likely to snack and graze later on, and maintain good nutrition.

Keep in mind that because we can't eat no where near the calories we did before surgery, it's even more important to eat good quality food and eat it regularly, regardless of whether we feel hunger. For me, skipping meals is not an option.