In April 2014, I underwent a Gastric Bypass surgery.

My highest documented weight was 327.8 pounds. That's not my highest weight ever, just the one time I happened to go to the doctor. I'm guessing my real high weight was somewhere north of 350 at one point. Anyway, 6 months after surgery, I'm fluctuating between 219.7, and 223.2 pounds depending on the day really... I'm pretty much where I need to be, but I'm now scared of the "sophomore bounce" (that 10-20 pounds patients typically gain back later on)...

My problem -- hence this post -- is that I'm having trouble caused by my nutritionist's demands that I "eat three meals a day +2 shakes" even if I'm not hungry...

I understand what she's trying to say. She is reading from the generic textbook and lumping me in with everyone else, trying to make sure I get my Protein and other needs met. The trouble for me is that her nagging voice in my head is causing me to do nothing but sit here and think about eating all day long... Because her idea of a "meal" and mine differ greatly, I'm truly scared that I'm doing myself harm by eating constantly just because it happens to be a meal time, or because I'm "supposed to" be eating 3 meals a day...

I'm constantly stuffed, sometimes to the point of being ill, but now I'm at the point where if I'm not eating, I'm thinking about eating, and that's scaring the bejeebus out of me.

I'm not specifically blaming her for my issues. I know this is all psychologically in my head, but I'm just trying to fight between her voice in my head urging me to constantly eat and my own "diet mindset" to simply not eat anything at all until I'm actually hungry... In the meantime, I've gone from 300 calories a day post surgery (liquid diet) to having trouble staying under 1500 calories a day now...

(For the record, when I ask her "give me a number of calories I'm supposed to stick to", she just tells me "I'm not worried about calories" which truly pisses me off, because I *need* some imperical number to serve as a guide...)

Any help or constructive input would be appreciated,

Wayne

Nutritionists just don't get it sometimes!! lol.

From what others tell me, it isn't that you should have a "meal" 3 times a day but that you should be eating some Protein 3 times a day at meal time, plus 2 more times for Snacks. BAsically, the way someone told me was to eat some protein every 2-3 hours. And, instead of counting calories, which we are all trained to do, count grams of protein instead. I don't know how much you need but I was told for me (or maybe for women) to get between 60-80 grams of protein in a day. That's the measurement I use instead of calories. And its's an "eat your protein first" rule. I'm also supposed to be counting grams of carbs now but am having trouble with that.

So, my day generally looks like this (when I'm doing it right)

Breakfast: 1 kashi bar, coffee,

about an hour later: 1 hard boiled egg

about an hour or 2 after that: yogurt (the Fit and Light yogurt)

Lunch: 2-3 oz. of chicken with some veggies from the salad bar, balsamic vinegar is my dressing

Around 3pm: cottage cheese

Dinner: 3-4 oz of chicken or ground turkey, or shrimp, or some kind of protein (sometimes edamame). Some veggies if I can.

Dessert: Protein Bar (the type I have depends on how many grams of protein I still need to get in), and some frozen grapes.

I have no idea how many calories that is but I do know this fulfills my protein intake. I also sometimes throw in some multigrain crackers with some Peanut Butter on them but I need to stop that nonsense!

Each ounce of protein has about 7 grams. (I also just looked at my spreadsheet that I keep and here is what I was told:

I would start with your post-op diet routine and track all the you eat.

Postop diet is 60 to 80 grams of protein, 30 grams of fats, and no more than 100 grams of carbs.

Eating Proteins first, then carbs and finally fats.

Counting calories drives me nuts but it is familiar. But I am now getting better at counting grams of protein.

Best of luck to you and don't stop doing the right thing!!! You can do it!

Thanks very much! I appreciate your advice and it all sounds right to me. I just want to lose that last 20 pounds, get to 199 before the sophomore bounce kicks in, and I'm afraid I'm being tripped up by her voice in my head telling me to constantly be eating "a meal"...

I'll see if I can get back to the post op diet to see if that kicks me off the 219 shelf and moves me towards Onederland..

Thanks again,

Wayne

I believe you have some flexibility. It is important to consume the amount of Protein required but how you do this is somewhat up to you. I am 18 months post-op from RNY gastric bypass surgery and ever since my surgery my meal plan has been in flux. I relied on home-made high protein chili and Soups for my meals. Since I am up to a cup per meal now, I gain around 60 grams of protein just from my meals alone. Your protein requirement is the combination of protein from meals combined with protein from supplements. As time went on I was able to transition completely off Protein shakes as a supplement. I hate the taste of protein shakes. Now my protein supplements consists of a hot cup of cocoa (no sugar added) in the morning and a berry smoothie in the late afternoon. I also found that Protein Bars (QuestBar) is a good source of protein when I am on the go and unable to use my Ninja blender.

I am 18 months post-op from RNY gastric bypass surgery..... Since I am up to a cup per meal now,

That's just it James, I'm 6 months out, and eating a cup, two cups, or even a cheeseburger isn't an issue for me any more as long as it's moist, I eat slowly and take small bites.

I don't really get full, just that "one bite, too much, you're sick" level of full. I tried explaining this to the nutritionist repeatedly only to be met with "you're funny" (as though she believes im joking) then she rides my butt about not losing more weight, when all I hear in my head is her yelling at me to constantly eat even when I'm not hungry...

I'm flummoxed..

This is YOUR weight loss journey. She is there only to guide you along the way. If you are hearing her voice constantly yelling at you, then you are in a state of stress and stress can cause you problems. There is a lot of flexibility available in your approach. I think I am consuming around 1500 calories per day now but I am also meeting my Protein requirements. But I have lost my weight and am in a maintenance mode now. If you are still in the losing phase, you might need to be lower in caloric intake. In the losing phase, your body is consuming fat and converting it into energy and as a result your body can survive on less calories.

Maybe get some flavorless protein powder and add it to the foods you are taking in when your hungry, so your not eating and drinking so much. Two birds, one stone. Best wishes.

@@going2servive, maybe I'm weird, but I could take in an infinite amount of protein and it wouldn't deter me from being hungry at all.

@@going2servive, maybe I'm weird, but I could take in an infinite amount of Protein and it wouldn't deter me from being hungry at all.

I tend to agree. I don't think protein does much for curbing hunger. On the other hand, I believe fat does. I have included some amount of fat in my diet and I use it to curb any hunger that might pop up. It seems to work for me. (I use real butter, real milk and home-made (no sugar added) whip cream. I use some meats that are not lean. I even use Adkin's Treats.)

Do you have a therapist? It sounds to me from your post that this isn't a battle between you and your NUT but may be more about your relationship with food (just a thought ).

Wayne, I am worried that if you stay in your current pattern you will gain more than just the sophomore 20! Have you thought about meeting with a therapist who deals with post gastric bypass patients? The surgery fixed you stomach but you have to fix your mind( cravings, obsessiveness or compulsion ).

@@James Marusek

I love my Ninja blender too! It was one of the better investments I have ever made!!

I am nowhere near as far along as most of you but I only eat 3 meals a day with no Protein supplement shakes in between my meals. I focus on getting 60+ grams of protein from my meals only. I think I may have had 2 or 3 snacks total( usually almonds) since my surgery. My NUT emphasizes getting off of liquid Protein as much as possible since liquids move through the pouch easier and faster than solids making us hungry faster.

Do you have a therapist? It sounds to me from your post that this isn't a battle between you and your NUT but may be more about your relationship with food (just a thought ).

Suddenly, I can't get Billy Joel out of my head... "You may be right. I may be crazy..."

Seriously though, The only time I've dealt with therapists (psychologists, whatever you want to call them) all they did was spout generic Weight Watchers BS at me -- much like my nutritionist is doing now.

I fully and openly admit that 75% of the problem resides in my own head, but what tends to push my buttons is that I'm not getting anywhere near the support I need from the people who're supposed to be providing it.

The mandatory 6 month "training courses" were nothing more than "weight watcher light" groups where the (same) nutritionist handed out pamplets telling us to "eat salads, not burgers, but don't use dressing" crap.

I'm taking what they're saying now too seriously because I want to be successful at this, and to be told cookie-cutter BS about "eat 3 meals, even when you're not hungry" -- quite frankly -- pisses me off. A bit moreso because now I've been shoehorned into the routine of eating 3 meals a day, even when I'm not hungry at all because -- supposedly -- "that's how you lose weight". See where that might be a bit peevish?

I know how to fix it, and it's all on me, but it means that I basically disregard what has been hammered into my head by the nutritionist, meaning that I'll have to listen to her kvetch about it later.

I'm just going to have to get back into the mindset of "yes, eat Protein 3 times a day, but only eat when you get hungry" rather than trying to adhere to the maddening "3 meals a day, even if you're not hungry" routine..

Now, I'm going to go back and rewind the Billy Joel running through my head and laugh about all of this for a while. See you at lunch..

Wayne

There is no one formula of how to lose weight. This is your individual journey and what works for others may not work for you. I've lost over 100% of my excess weight and have been maintaining below goal for 4 months. And this was without 1 single postop meeting with a nutritionist. I also never counted calories or measured my food. I haven't always eaten sugar free (artificial sweeteners upset my stomach the first 4 months) and never restricted my fats. I eat when I'm hungry and only until satisfied, not full. This may mean 3 times/day or eight times a day, depending on what I ate and what I'm doing that day. I get 30-40g Protein from a shake everyday and this frees me up to eat a balanced diet of protein, fruits, veggies and whole grains instead of having to load up on protein at every meal. Basically Just like a "normal" person. I think a healthy variety lends itself to long term success because I don't feel deprived.

I'm not saying to do it my way, I'm just saying there is more than one way. Seriously, with all of the nutritional education you've already gotten, plus ideas on here, and a little common sense it's not hard to know what and how to eat. Listen to your body, not your nut. Her generic instructions may not be the best for you. I say do it your way, while sticking with the general rules of Water, protein and Vitamins. If you lose, great. If you stall or gain, assess what and how much you are eating as well as your exercise, and make adjustments that fit your life (not what your nut's weight watchers handbook says).

Maybe there's a reason for the statistic of WLS patients only losing 65% of their excess weight....the "experts" only know what their talking about 65% of the time. Same goes for the sophomore gain. If you lost all your weight following restrictive, unnatural rules, then it only makes sense you would gain once you tried to maintain a normal lifestyle. No different than every diet we've ever been on. Just lose it in a way that fits your life in the first place (even if this means slower) and it will be easier to maintain that loss.

Good luck with those voices in your head ????

I think that what they call "meals" might not be how we envision meals.

I would suggest attending Overeater's Anonymous meetings as a place to get some support. Does your surgeon's hospital have support groups? Mine has 2. One is led by the nurse and, actually I'm not sure who he is--lol He may be a therapist. He mostly talks about us being food addicts and what that all means, etc. The other is led by the NUT and they talk about food or something. I have never been able to attend the one by the NUT. And frankly, my experience is similar to yours with regards to the NUT. She's a really nice person but she doesn't get it, or she doesn't get me anyway and has not been helpful at all. She just keeps saying to keep doing what I"m doing but that isn't helpful!! I don't know what I"m doing! (that's a rather simplistic phrase--so much more behind that but that's my issue not yours).

You need to take what she says with a grain of salt and do what feels right for you. Of course, it will take a lot of trial and error to know what feels right and what works, right?

Do you drink any fluids with your meals? This flushes food through your system faster and then you get hungry faster.

Do you keep a food journal?

Are you tired of all the responses now? lol. Sorry to pile on.