I am confused and hope the veterans can explain things better than the Dr did. However before I ask my questions I think you need some history. I weighed 352 pounds when I had my first consultation and we agreed on an ideal weight of 155. I was put on a 6 month pre-op diet which consisted of 3 meals a day and trying to get in 60 to 100 grams of Protein. I lost 37 pounds. I had my surgery Jan 26th and was told that starting at 3 weeks post-op I should be getting in a total of 60 to 80 grams of protein in 1 to 3 meals. I mainly had 2 meals where I could eat maybe 1 1/2 oz of protein food before I got a terrible pain. I was told by the surgeon the pain was my tummy telling me it was full. Therefore I was still drinking at least 2 to 3 Protein shakes and Soups. So most days I got 60 to 80 grams of protein.

So that takes us to today's 1 month post op visit with the surgeon. I do not have a NUT.He has been telling me everything I should and shouldn't be eating since the consultation. I lost another 23 pounds. For a total of 60 pounds since the first consultation. The surgeon claims since the first consultation I have lost 30% of my Excess Body Weight. He says now that I am that much thinner I only need 41 grams of protein a day and need to eat 3 meals only and stop drinking so many shakes and soups. However I can have 1 shake as one of my meals.

This is where I am confused as everything I have read over the last 7 months says 60 to 100 grams of protein.

Questions:

1. Was your protein reduced once you started to lose weight? If not, what grams were you eating at 1 month post-op?

2. I thought eating less than 60 grams would cause problems with my muscles and hair etc?

3. How can I get the 41 grams of protein down when I physically can't eat but 1 1/2 oz of protein food at a meal?

Even if I have 1 Protein Shake as a Meal Replacement that still leaves 11 grams of protein food in 2 meals. A half a cup of yogurt which is about all I can eat would only give me maybe 6 grams of protein.

4. What would you do, eat only the 41 grams of protein the Dr says to eat or would you continue to eat 60 or more?

5. Would you continue to drink more than 1 protein shake or Soup a day?

I don't want to mess up and gain weight but I don't want to become sick either because I am not taking in what seems to be the higher amount of protein that others are eating. Please help me figure out what to do.

Thanks everyone!

@@BarrySue thank you. The examples you posted actually support the favt that the body has a limited capacity for utilizing the amino acids from Protein for muscle synthesis.....

"Protein beyond what your body needs to replenish its amino acid pool (or can put to use for muscle building) is metabolized into glucose and used for energy. And whenever you have more food energy than you need, the surplus is stored as fat. Nothing is wasted"

So no, the protein you eat isn't "wasted", but if you consume too much too fast, it's no different than eating fats or carbs. Essentially only a certain amount of the protein you eat over a certain period of time can be utilized as a muscle building block. The excess is burned for energy or stored as fat. In other words, you shouldnt consume more than 10-20g protein/Hr or you might as well be eating candy bars. Your links actually support this theory.

Wrong, my links say the exact opposite. You are reading the same information, but coming to a false conclusion.

20g-30g protein is used for muscle synthesis at a time. AFTER THAT, protein is used for other essential functions and still has important uses (like making hemoglobin, metabolic hormones, etc). Anything over 10-20g is not suddenly fat; you are underestimating the tremendous energy expenditure used to convert protein into various other substances, and how much protein the body utilizes in functions BEYOND muscle synthesis. Given the size restriction of our stomachs, moderate exercise level, and low carb lifestyle, eating 80-100g of protein per day (in three meals rather than five) will not result in accumulating protein as stored fat. If a person eats 3,500 daily calories of dense, saturated-fat filled red meat without exercise, then yes, they could absolutely gain weight (and clog their veins, good lord). But that is an extreme scenario that doesn't apply to WLS patients.

There is a reason why bodybuilders trying to keep 5% bodyfat are on 200-300g of protein per day. Our bodies don't store it as glycogen/fat as easy as glucose, and it just kind of shows you have a limited understanding of just how much caloric expenditure goes into the various metabolic/structural processes of protein utilization.

High amounts of protein in fewer sittings simply work better. It's not a matter of opinion. It's a matter of science:

http://www.ncbi.nlm.nih.gov/pubmed/26817506

http://www.ncbi.nlm.nih.gov/pubmed/16469983

http://www.ncbi.nlm.nih.gov/pubmed/8700446

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577439/

http://www.ncbi.nlm.nih.gov/pubmed/16779921

I'm not trying to be a jerk. I completely understand that you have much knowledge and experience with the weight loss process, and I know you are trying to genuinely be helpful and pass along information. But it's very important to me as a nurse to continue to ensure people have accurate information and understand some of the complexities behind nutrition rather than falling prey to myth/misunderstanding.

*******Edit: here is a very simple, easy to understand short response to why your protein will not turn to fat, because those peer-reviewed articles I linked are dry, boring, and difficult to understand : http://www.bodyrecomposition.com/nutrition/excess-protein-and-fat-storage-qa.html

Edited February 27, 201610 yr by BarrySue

Sorry, I was simply quoting the article you provided. And the new articles you posted continue to support my position that our bodies are indeed, limited on how much protein can be utilized over a given period of time. One of your articles specified that the gastrointestinal tract can only absorb protein at a rate of 1.3-10g/hr. It goes on to include our liver's ability to properly excrete excess nitrogen as a limiting factor of what is an acceptable protein requirement as well. Another article indicated that protein intake in excess of 30-40g post workout has no added anabolic benefit. The other articles simply confirmed what we already know....high protein/low carb diets are beneficial for weightloss. So again, thank you for your links.

So the last link is claiming you can't get fat from eating Protein OR carbs (at least not in a "real world" setting)....

"Make no mistake, the conversion of carbs to fat (a process called de-novo lipogenesis or DNL) can happen but the requirements for it to happen significantly are fairly rare in humans under most conditions (to discuss this in detail would require a full article, interested readers can search Medline for work by Hellerstein or Acheson on the topic).

At least one of those is when daily carbohydrate intake is just massive, fulfilling over 100% of the daily maintenance energy requirements. And only then when muscle glycogen is full. For an average sized male you’re looking at 700-900 grams of carbohydrate daily for multiple days running."

So WTH are we bothering with a low carb diet? And sorry, but do you know how much weight I'd gain if I added a couple candy bars to my daily diet? Which is far less than the 700-900g he's talking about. Sounds like he needs to get out of the lab and into the "real world"

So Thursday I got only 52 grams of Protein and yesterday was even less like 29. I biked 3.05 miles on Thursday. Yesterday and today only 1.64 each day. Friday and today I feel so weak and tired. So this 2 days experiment kind of proves to me at least that I NEED that 60 grams and more of protein per day.

I am sure you all agree with that statement.

Barrysue and Kindle thanks for the added info and links on this subject. It made for very interesting reading.

So Thursday I got only 52 grams of Protein and yesterday was even less like 29. I biked 3.05 miles on Thursday. Yesterday and today only 1.64 each day. Friday and today I feel so weak and tired. So this 2 days experiment kind of proves to me at least that I NEED that 60 grams and more of protein per day.

I am sure you all agree with that statement.

Barrysue and Kindle thanks for the added info and links on this subject. It made for very interesting reading.

I am glad you are finally discovering this.

My concern/question is why have you not been tracking your protein with the goal of meeting your protein goal all along? Did you not receive any nutritional education from your surgeon, NUT, and/or bariatric team? This is such a vital part of post-op nutrition it is still amazing to me that so many people seem to not know this.

I really am just curious.

Edited to add: never mind, I just realized that it was your surgeon giving you this advice. SMH.

OOPs I just read your OOPS. LOL

Apparently you didn't read the original posting otherwise ou would have discovered I was trying to meet the 60 grams post op 1 month goal. The Dr told me yesterday to drop down to 41 grams of Protein now that I weigh 32% less than when I started. I track everyday at myfitnesspal. I do not have a NUT

I'm not sure why excess protein in one sitting is even a debate for us, unless you are drinking it, and chugging it at that, it is pretty hard for a weight loss patient to consume in excess of 30g of protein in one sitting. If I am eating dense protein somewhere between 20-25 is my max.

I no longer propose that everyone's body metabolizes food the same way or that there's a single formula for the number of macronutrients (protein, carbs, fats) at which everyone's body is happiest losing weight or maintaining their weight.

But I do seriously believe that you need more than 41 grams of Protein daily to retain muscle tissue as you lose weight (whether you're doing weight resistance exercises or just cardio exercises or just moving your a** more than you used to).

I will volunteer that for most of my weight loss phases I ate 80-100 grams of protein daily. I also ate plenty of carbs (my own body is amazingly carb-tolerant), and didn't even worry about the fat.

I've lost 100 pounds and am maintaining at 135 pounds.

I hope you figure this out fast. I really don't think your surgeon knows what he's talking about nutritionally, though.

And protip -- not all nutritionists or even dietitians know what bariatric patients are dealing with. I hope the one you see is better educated than all of mine were.

Okay, @@ssflbelle,

There are a few issues here, all mixed up!

Protein goes towards supporting your lean muscle mass. You have more of it when you weigh more. When you lose weight, you’re not just losing fat, you’re losing lean muscle mass, too. You try to minimize loss of lean muscle mass by eating a lot of protein and by exercising, but you still lose some. So, when you weigh less, you have less lean muscle mass than you did before. So, your protein needs go down.

I think your new doctor may have come up with that number of 41 based on your absolute needs for survival and general health. People don’t need nearly as much protein as we tend to eat. But since you’re still losing weight, I would think you’d still be aiming for a little more to protect your lean muscle mass.

Now, eating more protein than your basic needs (those 41 grams, say) can also be good because it keeps you fuller than if you got those same calories from carbs like refined starch or sugar.

As for eating 3 times a day, yes, your body can absorb enough protein to meet your protein needs in those 3 meals. But if you can’t get in enough food/shakes/protein at those meals, you’d better add one or more Snacks.

I’d either get the doctor to give me an explanation that made sense to me, or look for another doctor if that’s a possibility! It just seems strange that this doctor’s advice goes against what most doctors say.

Good luck!

Thanks Alex for your input into this topic. Your right the topic did divide into many other topics. However it is all good and was very informative.

I gather from what you wrote only being 1 month post op you would stay with the 60 grams of Protein? As for changing Dr this is the one that did the 6 month pre-op diet with and the 3 surgeries and I have all ready had a 1 week and 1 month post op. I doubt now would be a good time to change to another Doctor. My 3 month post op is April 20th and hopefully by that time the Dietitian will be on staff working full time.

I was sleeved four years ago at a COE. Their recommendation was 60grams per day. Now, they say 80. I don't know why the change but they follow alot of patients and also the research and adjust recommendations based on that. I find maintenance easier if I have a little higher Protein, but I also have more capacity now. Plenty of surgeons are still saying 60g plus.

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