Seeking advice for those of you who have followed healthy post-op advice. A good friend had the gastric sleeve surgery only 4 months ago. To date, she continues to take in no more than 500 calories per day, and has worked up to exercising for 2 hours or more at least 5 days out of the week (that part of the routine has been for the last 2-1/2 to 3 months). She is still taking Vitamins, but admits that she has a challenge with sufficient Water intake when she gets "too busy".

Is this truely a recommended routine for most gastric sleeve patients, or should I be concerned that she is developing an eating disorder? I may have misunderstood, but my thought is that she would have been encouraged by her nutritionist and physician to bump up her calories gradually as she has become strong enough to increase an exercise regimen. I've been trying to express my concern while attempting to avoid seeming unsupportive or critical of her. Thanks in advance for your advice!

It is very good that you are concerned about your friend. I am still pre-op and am scheduled to have surgery on 9/15. After getting "sleeved" it us very hard for a person to get in enough of the recommended protein wand ter intake. It is very important for her to make sure she gets in enough water because without the water intake she is at risk for becoming dehydrated which will land her back in the hospital. Every surgeon is different buy most recommend you get at least 600-800 calories a day and might even work up to 1000. Because her stomach is a lot smaller now it's not as easy to take in a lot of food. I don't think she has an eating disorder. As a lot of people who are post op says it's hard to eat. You become very forgetful because you don't have the urge to eat it's like you have to force yourself to do so. In my opinion you should just tell her how you feel. Ask her what her surgeon and nutritionists think about her intake and about the amount of exercise she is doing..she might be very appreciative to the fact that you are concerned about her health. .good luck to you

My question is ..... is she still losing weight? I am 8 1/2 months out and still at 800 calories, 80 ounces of Water and 80 grams of Protein.....quite the balancing act to reach those goals at the same time. I couldn't lose weight before at 1000 calories (5'4 and 235 pounds), so with a sleeve, 800 seemed to be a good place to settle. My nut adviised 800-1200, but as soon as I approach 900. the ounces start creeping back.

However, I have been on a plateau for six weeks, stuck at 172 +/- a couple of pounds. For me, 800 calories does not provide much energy or support much exercise. Actually, it was easier to have an eating disorder when I weighed a scant 108 at the age of 21. I don't know what to tell you except that I would fall over from weakness if I had her exercise regime.

Starvation / starvation mode.....the concept is elusive right now. I recently had one of those hydration visits back to the hospital after being very ill with diarrhea and passed out and hit my head on the tub twice in one night. I was reminded that laxatives are not the way to restart weight loss, either. I have a visit with a new nutritionist coming up and will ask where she sees the balance. I wish your friend well and hope she finds a healthy balance for herself. She is lucky to have a concerned friend like you.

500 calories is just not enough if she is working out that much. It does sound obsessive to me. I would imagine she will not be able to keep up that kind of pace forever. I was that way in the beginning. Now, 5 years later, I'm thrilled with the sleeve, but I don' t have to work as hard to maintain as I did to lose.

It is great that you are so concerned about your friend. I also admire your sensitivity in coming here to ask for advice rather than confronting your friend. It is very hard to hit your caloric and Protein goals for the first few months after surgery. This is a common problem and does not, by itself, indicate any disorder.

If your friend is developing a disorder, she might become defensive when questioned about her eating/exercise habits. Since you don't know whether or not she has that problem, it's better to offer her advice about the problem you know she has - not getting enough Water. There are lots of helpful hints on this site to cope with this issue. At 500 cals a day it is also possible that she isn't getting enough protein. You might be able to ask her about that without making her uncomfortable. And you could suggest that she talk to her nutritionist for tips on raising her intake.

No advice. You're a really nice and considerate friend though.

No advice. You're a really nice and considerate friend though.

I'm still only in my second week post op so I don't have much contribuite, but I have read ALOT of these forums. I'd just like to warn you to tread very lightly in approaching eating habits with your friend. I've read so many posts where people think their friend is unsupportive or is trying to sabotage them. I don't want that to happen to u. I agree with the idea to encourage more water intake. Especially with exercising that one is important.

I'm still only in my second week post op so I don't have much contribuite, but I have read ALOT of these forums. I'd just like to warn you to tread very lightly in approaching eating habits with your friend. I've read so many posts where people think their friend is unsupportive or is trying to sabotage them. I don't want that to happen to u. I agree with the idea to encourage more Water intake. Especially with exercising that one is important.

Ugh, my kid hit send before I finished my thought.

I was going to suggest not being as concerned with calories as Protein. Maybe u can buy the protein shots for you both and go exercise with her. Afterwards give her one and tell her u read it's good post workout (which is true). Each one is 180 calories and 42g protein.

Best of luck!!!

Thanks so much, everyone, for your thoughts, knowledge & experiences! I'm so appreciative of your support.

Some answers:

- Yes, she has lost weight quickly since surgery and it continues, reporting that she has lost almost 70 pounds total. Her surgery was in mid-May.

- She admitted to me today that she wants to keep her food intake at 500 calories or below until she gets to a goal weight.

- She seemed to respond vaguely to my question regarding if her nutritionist and surgeon think hers is a recommended routine. I stopped there.

I can see why so many have perceived lack of support from friends who haven't experienced the surgery. I would hate to be seen as one of those friends too, but am preparing myself for that if my good intentions are not received as such. I sense signs of that already, and it makes me sad, but I want to be an honest and as true a friend as I can about her situation. Whether this is beginner's ambition, common behavior or a potential eating disorder, I'll do my best to show that I have her best interests at heart.

I'll gladly take all of your feedback into consideration before talking to her again, and will definitely approach her gently on Water intake to start. I saw the perfect water bottle the other day, and will offer it as a gift. Sharing Protein shots after a workout is a nice, gentle touch too.

I'd like to keep this discussion open for follow-up. I'm sure I'll have questions and may seek more support after our first conversations related to this topic. Wishing you all the very best in your personal journeys, and I'll write again very soon.

@@snowkitten, I agree with you. I should've completed my thought. I meant that this person is a really nice and considerate friend to even care, and cognizant enough to seek advice from this forum so as not to offend the friend.

Kudos to the OP for trying to adapt, support, and maintain a good friend - instead of being bitter, non-supportive, or undermining her weight loss efforts.