Maintaining on lower fat

[bikrchk 1,313]

So, I'm 2+ years out and had what I suspect was a gallbladder episode a few nights ago. Woke up projectile vomiting 5 hours after a rich meal. (Rich in good fat, salmon, olive oil, etc) I palpated around and nothing hurt to the touch. Problem was over as quick as it started. Went back to bed felt okay the next day, (minor soreness probably to be expected). Went and got checked the next day at the PCP's office, (my surgeon moved and the bariatric program kind of fell apart so no support there) and the nurse practitioner was like, yeah, could be, but since it was the first episode probably don't need an ultrasound. Try cutting some fat out of your diet.

Okay... So I've done that, and do feel better, however, I've lost a little weight already. I don't really NEED to lose at this point, but 10 pounds would be okay. No more though. So I've been maintaining my weight on a certain calorie level (1300-1500) mostly supported by full fat dairy and "good" fats in nuts, avocado, salmon, olive oil, etc. I've gone back to logging so I can keep track of the fat, (I WAS eating a lot, I think), but now, keeping it below 30% (around 40g per day which doesn't seem that low to me), I struggle to get 1000 calories per day, (even when I eat 5-6 small meals per day). I have an exercise habit, stationary bike at home, nothing extreme, that burns 400-500 per day. What am I going to look like in 2 months?

Should I be concerned?

[JamieLogical 8,727]

Ooh, this sounds like a tough one. I've had to add a lot of fat back into my diet to try to slow down my loss now that I'm at goal. Like you I do full-fat cheeses and nuts to help increase my calorie intake without having to increase the volume of what I'm eating. I don't know what I'd do if I could rely on those higher fat options to get my calories up. I'd hate to resort to more carbs/sugar, but that might be your only option at this point. Trying to pack in more Protein as a calorie-source will probably be pushing the limits of your restriction.

[Threetimesacharm 1,400]

An easy way to get in more calories/protein is by shake. Are you not able to consume more than 1000 calories because you physically can not? There are higher calorie Protein options beef, pork, chicken even have more calories than fish. How about Beans higher in carbs and calories most in half a cup are around 200 calories easy way to keep calories up and fat down.

[bikrchk 1,313]

Oh, did I mention I'm already getting 80-90G of Protein per day?. I still do a scoop of whey in my coffee and if I'm less than 80 for the day, a Quest or PowerCrunch later, (if I can fit it in my belly, LOL). I did purchase some dried fruit, (yeah, high sugar, but whatcha gonna do?) to add as a snack. I had been drinking a glass of wine at night as well which created a calorie bump, but it's been making my tummy icky so I quit that too. :-/

I may just see what happens. If 2 months from now, I'm at or below 135, I'll be back at the Dr, (my actual PCP, not the NP) saying "WTH" was THAT advice? In the mean time, there's a support group from another clinic locally that I sometimes attend. I may check with their Nut and coordinator to see if they have advice or see if their docs ever accept other patients. I've changed jobs, so if it has to come out, it'll likely be at this hospital anyway.

[Djmohr 6,965]

I definitely think you should talk to a nut who specializes in Bariatrics. I am not sure what would do in this instance. I simply cannot add any more volume and rely heavily on good fats and full fat dairy now. I swear they keep me fuller longer. Some days I am lucky to get 1000 calories in but the max for me has been 1200. I eat 3 meals a day and 3 Snacks to get there.

I am just 10lbs from my ideal weight goal and really don't want to lose much more than that. I could maybe tolerate another 10lbs but would prefer not to. I have to figure out how to increase my calories without eating crap. I am a chronic kidney disease patient and have been told to eat no more than my 70 grams of Protein per day and even with that my BUB is elevated. Adding Protein will not be an option for me.

Good luck to you, I hope you are able to figure it out.

Bun is elevated not BUB! LOL

[VSGAnn2014 12,992]

You probably remember, but I had my first-ever gall bladder attack 10 days VSG post-op and then had my gall bladder out 4 weeks post-VSG surgery.

Recovery was easy-peasy, and I've had zero problems since than.

Is surgery not an option for you? Have you had an ultrasound? If you have an ultrasound you can see the stones -- they're very bright.

Things that I find offer me more calories (which I also need in maintenance -- I'm maintaining now at 138 pounds) include high-Fiber, high-Protein crackers with (sorry) cheese or meat or jam (or all three) on top. I'm also eating a lot more brown rice these days. Also dark chocolate.

You could try regular bread in addition to the high-protein bread you love so much.

Sounds like it's time for an extra snack or two each day.

Good luck!

[bikrchk 1,313]

You probably remember, but I had my first-ever gall bladder attack 10 days VSG post-op and then had my gall bladder out 4 weeks post-VSG surgery.

Recovery was easy-peasy, and I've had zero problems since than.

Is surgery not an option for you? Have you had an ultrasound? If you have an ultrasound you can see the stones -- they're very bright.

Things that I find offer me more calories (which I also need in maintenance -- I'm maintaining now at 138 pounds) include high-fiber, high-Protein crackers with (sorry) cheese or meat or jam (or all three) on top. I'm also eating a lot more brown rice these days. Also dark chocolate.

You could try regular bread in addition to the high-protein bread you love so much.

Sounds like it's time for an extra snack or two each day.

Good luck!

All the stuff you mention... cheese, crackers, chocolate etc, that what I WAS eating. I munched seed crackers all day long dipped in cottage cheese or with baby bells between meals. Then chase dinner with a glass of wine or single serving ice cream treat and maintained. I added some pretzel crackers to lunch today (much lower fat than the seeded rice crackers I had been eating) and apparently got too much, (had to lose some of it as I was over full and ready to puke). More food, even Snacks... just no more room.

We'll see if weight loss turns out to be as big an issue as I expect with a cleaned up diet. I really was maintaining eating pretty much whatever I felt like in small quantities, though I eat pretty clean during the week. The NP I saw didn't think an ultrasound was warranted... yet. If I lose more than 10, I'll be back with my PCP telling her I got bad advice (for a maintaining bariatric patient). I think you may be right, if it's stones, even if they are not severe, keeping the symptoms in check with diet may not be an option for me.

[jess9395 5,450]

Can you try drinking more calories? Orange juice has a lot of Vitamins along with the sugar. Nonfat or 1% milk. You could even throw that Protein Powder you put in your coffee into milk instead. A cup of nonfat is 70 calories and 1% is 90.

[James Marusek 5,244]

I don't think you should be concerned at this point about your diet. Give it a few months and see what happens. The direction I received from my nutritionist was eat 3 well balanced (Protein, fat, carb) meals per day and avoid grazing. I mentioned that I still found it difficult to eat more than a cup per meal. She said then try eating 4 meals per day.

The gallbladder is a different story. If you have reoccurring episodes, this might need to be addressed.