Advice, Please - Surgeon vs. NUT

[Mini_me007 121]

Regarding calories, carbs, etc.---who do I listen to? Surgeon's Bariatric NP or NUT?

Here's the deal:

When I started this journey, my surgeon's office had a NUT who did all the pre-op stuff. She has since left and for reasons I don't want to go into or I'll get ticked off, they no longer provide a NUT to patients. I've been limping along on advice I got here until I started going to my surgeon's office for follow-up visits. I see an NP there.

The NP has always made me a little nervous as I don't think she seems super-knowledgeable, especially as she's supposed to be a Bariatric NP. During my last visit, I told her I didn't think I was getting enough calories or something because I'm tired and/or hungry all the time. She looked over my numbers (I keep track of everything on MyFitnessPal). I was at around 400-500 calories per day, 70-90 grams of Protein and around 20-30 grams of carbs. I exercise 5 days a week, 30-40 minutes a day. She told me never to go over 75 grams of protein a day, and I needed to keep my carbs below 30 grams per day.

Although I know all surgeons are different, I still knew something was wrong as my lab work came back fine, so I decided to get my own NUT to get this stuff straightened out. The surgeon's office referred me to one. I saw her today, and it was an eye opener! She said my calories were way too low, my surgeon's insistence on fruit being an every-now-and-again, once-in-a-blue-moon-treat was ludicrous, my protein intake needed to be 60-80 a day, and my calories need to be closer to 800 a day.

Even though I'm tired and hungry, I AM losing weight really well despite some health issues that can make it hard (Polycystic Ovarian Syndrome and medications). Do I listen to the NUT, increase my calories/carbs and start eating fruit, oatmeal and other carby foods? OR, do I listen to my Surgeon's Bariatric NP, and keep carbs and calories super-low?

I just want to continue losing weight, dang it. If adding way more carbs/calories now slows or stops my weight loss, I'll be devastated.

To whom should I listen?

[Inner Surfer Girl 12,015]

As your NUT's advice sounds much more in line with mine, I would vote for your NUT.

[2goldengirl 2,076]

I would follow the NUT advice and see how you feel after a couple weeks.

[Mini_me007 121]

@@Inner Surfer Girl @@2goldengirl Thanks!!

[FrankyG 1,450]

I'd go with the NUT's advice too.

With your carbs and calories that low, I'm surprised you have much energy to even get out of bed most days!

Low carb is great, but 50-75 grams is more in line with what I'd be shooting for, as you need some (healthy) carbs to provide energy. And your calories are extremely low too, and that is crazy to say keep your Protein BELOW 75 grams.

[ssflbelle 829]

Sounds like that NP needs more training and knowledge. I have never heard of keeping Protein below 75 that is crazy. I would follow what the NUT said. Good luck!

[Mini_me007 121]

@@FrankiesGirl You're so right! My energy levels have been brutally low. Hoping these changes help!

[Heather Birdwell 57]

My surgeon said at least 60 grams of Protein a day, and no more than 60 grams of carbs. Protein first and if my carbs are coming from natural things then I will do fine. That was basically his way of saying the processed foods should be avoided. I don't have a nutritionist and I am ok with that. I am 5 months out and down 72 pounds. Started at 289 and I am down to 217. I am 5'9". I have not been as great about getting in all my walking and working out but I am working on it. I would listen to what the nutritionist says. It's more in line with what I hear.

[Mini_me007 121]

@@ssflbelle @@Heather Birdwell Thanks to you both! I appreciate your help. :-)

[newmebithebypass 713]

I use the nut at my Surgeons office and she said 60-80 grams a day for life for Protein and less than 80 grams of carbs a day and not to worry about calories at first

[Mini_me007 121]

@ Thanks!

[omerbasa2807 12]

I would go with your NUT. I'm 6 weeks post-op and last time I saw my NUT she told me my Protein intake for now it's ok between 50-60 but it'll increase as I progress.

[Mini_me007 121]

@omerbasa2807. Thanks! I agree.

[omerbasa2807 12]

@@Mini_me007 you are very welcome

[VSGAnn2014 12,992]

Your new NUT is much smarter than the old (second?) one.

FYI, here's what I did (on the advice of my VERY GOOD bariatric P.A. who is totally up on all things bariatric and the newest research). She urged me NOT to stay on the 800 calorie diet for all my weight loss phases because she said that would discourage my body from accustoming itself to a "normal-sized" maintenance calorie budget.

Months 1-4 - averaged 800 calories, at least 60 grams Protein, and didn't worry about carbs. (It would have been hard for me to eat much more than that the first few months.)

Months 5-6 - averaged 1000 calories, at least 75 grams Protein, and didn't worry about carbs, although I focused on healthy, colored veggies, a little fruit and a little bit of whole grains.

Months 7-8 - averaged 1200 calories, aimed for 100 grams protein and added more carbs.

FYI, I stayed away from sugar and all slider foods during all the weight losing phases.

I hit my initial weight loss target (150 pounds) at 8.5 months post-op. Then while aiming for 1700 calories daily, I lost another 12 pounds during the next 6 months, where I'm now maintaining happily at 1700-1800 calories/day on average.

I'm still eating 100 calories of protein most days. Needless to say I've been able to "branch out" into a wider variety of carbs, but I still eat pretty clean. Now on most days I also drink wine, some high-Fiber, high-protein crackers, and a couple squares of dark chocolate. I also sometimes eat Pasta, pizza, burgers (much smaller portions than in the past).

Most days I still pre-plan my menus and measure and track my food using www.myfitnesspal.com, so I really do know how much / what I'm eating. And I weigh every morning unless I'm traveling.

Life is very good.