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Need some advice and a diet overhaul: 2 years post-op, 75 lbs down

I had DS in March of 2014. I was 290 pounds at the time, down from my all-time high of 328 pounds pre-insurance requirements. I'm 5'3" tall, single, female, and in a demanding graduate school program which will wrap up in May of 2017.
I am now at 215 pounds and have hovered around this weight for several months now. I am disappointed in myself for only having lost 75 pounds though when it has been almost 2 years since my surgery. I would like to get down to a healthy BMI and do not care as much about the size that I am, but I do want to get rid of my "hanging apron" stomach as I think it really messes with my self-esteem.

I know that others have had much more dramatic weight loss and have probably given more attention to this process than I have. I also stress eat junk food -- Doritoes, donuts, etc. basically, I am a terrible post DS person! I know there is no excuse but I am in a demanding graduate school program and travel back and forth to take care of two sick parents, one of whom has stage 4 cancer. I chose to get the DS while I was working and still had good health insurance that would cover it knowing that I would be selling my place and moving across the country 5 months later -- so I was prepared for the fact that a lot of different changes would be occurring in my life but thought that I could still focus my energy and attention on this aspect of my life as well.

Unfortunately, I am not doing so well. I am overwhelmed at school (though earning mostly straight A's) and struggling with depression -- thinking about my parents, my general dissatisfaction with my life (I'm resetting my career but will be 35 by the time I graduate next year, unhappy that I am still single, and do not feel good enough for guys because of my current weight, and feel like I only have a handful of good friends in my program, and many of my friends who I left behind are now married and starting families and busy in that transition. Also I am not one to go out binge drinking and my Masters program trends about 5 years younger). The only thing that seems to be turning around is my career, and I am starting to find some good leads for what I can do when I graduate in spring of 2017.

Over the past few weeks, I have been trying to turn my life around when it comes to my health and have tried to focus on myself rather than to be sad about not having as many good friends anymore. (I have enough that I have someone to spend time with at least 2 times a week and really need to just be okay with that). I came to grad school to change an aspect of myself that I was unhappy about (my career) and feel that I should also focus on the other aspect of myself that I am unhappy about (my weight) as it could affect my long-term health, chances of developing cancer and heart disease (like my parents). I am starting to cook more, which I previously did not do. I joined a gym and go for 3-4 hours a week. I need to learn how to use my DS "tool" to my advantage though. I know that I lose when I eat a lot of Protein and less junk food. But I don't understand how much I should be eating to lose, as before I was losing about 2 lbs/week without thinking about it much. I went to see a nutritionist but she is unfamiliar with DS and could not give me any insight. I have seen her twice and gotten some general cooking advice and strategies for planning meals out on the go (since I am at school from morning -- like 8 AM until 8 PM at night some days). I also no longer live in the city where I had my DS and thus do not have access to those nutritionists.

I am trying to focus on the positives like how I reversed my GERD and diabetes and am in much better shape But I am also mad at myself for letting assignments/grades and what is going on with my parents has caused me to revert to old habits and stress eat. I also feel like I barely ever have enough time to sleep let alone do anything else. Hence, I am trying to implement small changes. This week, that has been to try to avoid eating donuts and muffins and to instead give me a weekly allowance of 2 sweets but to have them in a smaller, calorie-controlled format.

I welcome and appreciate any advice and support people can provide, as I am starting to feel pretty hopeless that I have come so far and am just "stuck" now.
  • Replies 34
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  • Author

People who have had DS have both a sleeve and intestinal re-routing. The latter means they only absorb approximately 60% of the complex carbs they consume, 60% of the protein, and 20% of fat. They absorb all simple sugars/carbs though. Hence donuts, cake, cookies, chips, are all fully absorbed.

Edited by watchmeshine8

Have been thinking about it and 100 grams a day of Protein amounts to only 400 calories since there are 4 calories in a gram of protein and 4 in a gram of carb (but 9 calories in a gram of fat). How many calories are we supposed to be trying to eat a day then? Seems like people could even be eating close to 1000 a day and if only half of that is absorbed (assuming it is comprised of complex carbs and protein) that means we are at 500 calories a day and should be losing very rapidly. Something doesn't seem to add up.

Our bodies are complex systems, not simple machines.

Until you are getting enough nutrition: protein, Water, Vitamins & minerals, and calories (fats & carbs), your body is not going to easily give up the extra weight.

People who have had DS have both a sleeve and intestinal re-routing. The latter means they only absorb approximately 60% of the complex carbs they consume, 60% of the Protein, and 20% of fat. They absorb all simple sugars/carbs though. Hence donuts, cake, Cookies, chips, are all fully absorbed.

Thanks, I was not aware of that. I didn't research this option when I was looking at WLS.

I guess that means you need to eat 100+ grams of protein everyday to hit your protein goals?

  • Author

Yes, to prevent protein deficiency. Having the benefits of malabsorption means that you can create larger caloric deficits (and hence lose more weight) but you can also suffer from nutrient deficiencies.

I can't give dietary advice for a DS, but some life advice (I have been through very difficult times as well - sick and dying family, my child's issues, career stress etc). here is what i have learned, everything is more managable when you feel better, when your health is better. Stop eating junk, get a little exercise (even walks!), make your health a priority, meditate, do self care etc and these other things are less likely to drown you. just eliminating junk food will make you feel better within a very short period of time. Take care of yourself - you have alot going on.

@@watchmeshine8 From reading your posts, it sounds like you know what you need to do and you could use some encouragement and support.

It seems that stress is your No. 1 problem. You sound overwhelmed by so many things going on in your life and understandably so! I strongly urge you to seek out a therapist or counselor. Is there someone on campus you can talk to? Do you at least have friends you can vent to?

I'd also suggest seeing your primary care doctor or a psychiatrist to evaluate whether you need medication for your depression. Even if it's triggered by identifiable outside stressors, medicine can help. I've taken Lexapro since before surgery and it hasn't stopped me from losing weight. Also, is it only depression or anxiety too? If it's anxiety too, you may need one step up from the starting dose (e.g., 10 mg lexapro works for depression, 20 mg works for anxiety).

In your last post, you said you know the muffins, doughnuts, chips, etc are sabotaging your diet. Can you find a way to cut them out or replace them?

I'm five months out from RNY and cravings have come back. Eating Protein helps satisfy my actual hunger. For head hunger, I know this sounds hokey but I've been using a mantra: "food is fuel." That's my way of reminding myself that I only need food to fuel my activities. I ask myself if I want to eat because I have physical hunger and need the fuel or I want the pleasure of munching on something. It keeps me from eating when I'm not hungry and helps me stick to on-plan foods.

Exercise also really boosts my mood and helps with my eating.

For Water, do you like crystal lite or other flavoring packets? That might get you drinking more and give you no calorie treat.

Hang in there and keep us updated!

Smart of you to reach out. You have a lot on your plate.

It looks to me like you took a vacation from your plan. To make it work again you need to go back to basics. You were having headaches because you were going through sugar withdrawal maybe try a weekend of Protein shakes to refresh and start slow again like you did in the beginning.

You know the drill. Protein first. Hit your Water and protein goals. Track every bite you put in your mouth on an online tracker.

Your food has to be your number one priority. Without a healthy body you are useless to your parents and what is the purpose of all the schooling if you aren't healthy to have a career.

It will get easier. You are number one. Treat yourself with the respect you deserve.

The suggestions about seeing a counselor are on point.

Best wishes!

Sent from my iPhone using Tapatalk

Hi! I am just starting the WLS journey but have attended some nutritional classes as part of my supervised weight loss requirement for the insurance company. My NUT is having me work towards the following eating plan in preparation for surgery. 4 - 5 mini meals every 3 - 4 hours apart. Each one must have a lean Protein to total ~90g daily. In addition, I can have 2 fruits, 3 healthy fats (including nuts, olive oil), 3 or more non-starch veggies, and 2 starches total to fill out each meal. The rule is to NOT eat between the meals. No grazing. If I find that I get ravenous between the meals, I can add more protein and non-starch veggies. She says that if I eventually follow this plan, cravings for sugar and bread will eventually decrease.

Double post.

Edited by Postop

Have been thinking about it and 100 grams a day of Protein amounts to only 400 calories since there are 4 calories in a gram of protein and 4 in a gram of carb (but 9 calories in a gram of fat). How many calories are we supposed to be trying to eat a day then? Seems like people could even be eating close to 1000 a day and if only half of that is absorbed (assuming it is comprised of complex carbs and protein) that means we are at 500 calories a day and should be losing very rapidly. Something doesn't seem to add up.

Hi,

You need to remember DSers don't count calories. We're most concerned with protein grams. The Cookies you're eating: the calories aren't the problem; it's the sugar grams. DSers absorb 100% of sugar and simple carbs. But that means we can eat tons of protein and fats. We can also eat constantly. There is no such thing as grazing for us. I eat every couple of hours. I always have nuts with me. I eat Swiss cheese and cold cuts on the run. Even a protein bar( < 8 g arms of sugar) might be good for you. Or how about this: I don't want to feel deprived. So I'll often (just did it) go to a Burger King or other FF restaurant and order a triple with cheese. I love it and the meat and fat do nothing to me. The more protein I eat, the more I lose. The trick is to eat inside the bun. I don't want the bun b/c it's too filling and I don't want the carbs. I'll get 2 if I want it. You need to try and start thinking like DSer again. Remember this is a great surgery for those who want to eat!

Eat tons of protein ( I eat 125 grams+ a day and more when I want to lose ) and get your liquids in. You'll lose.

Edited by Postop

There is no reason that you can't have Dannon Fit and Light as a snack. Most of us do. It's those regular yogurts that have 4 or 5 grams of Protein and 15 or more carbs that you need to avoid.

I freeze half a banana and put it in Protein drinks. I find they keep me full longer. Bananas do have a lot of carbs in them.

If you're going to eat oatmeal, eat steel cut oatmeal.

Do you like dill pickles? I find a dill pickle with a piece of lunch meat and a piece of cheese rolled up around it to be very satisfying.

If you really have to have something sweet, have a sf popsicle or sf fudgesicle.

  • 2 weeks later...

I am a DSer 3 yrs out. You and I have some similar issues. Maybe you can benefit from some of my experiences.

Keep your carbs limited to complex carbs (brown rice or low carb bread) and start your limit at 50 carbs a day. If you are not losing weight at 50, drop it to 40 carbs a day and test that out for 2 weeks. If you don't lose weight... you know the drill. I had to drop my carbs down to 20 per day before I would start to lose a pound or two per week again.

Eating sugar like sweets and juice only lead to cravings of more sugar. It acted like an addiction for me. If I stayed off the sweets for 3 weeks, then I could walk right past them and not want them. But as long as I as I was eating them, I had to have them every day. Vicious cycle. Not to mention the righteously OMG gas it causes - YKWIM!

Start packing your Snacks. Make your snacks from Protein and fats. Veggies are nice for a break, but the protein will give you endurance through the day and make you feel foll. Use hard boiled eggs, nuts, cottage cheeze, yogurt, string cheese, block cheeses, deli meat wrapped in lettuce with mayo (in a sandwich bag that you eat right out of the bag during your break), etc. Pack that in your school supplies to eat and start leaving lunch money at home (till you kick the sugar cravings and stop buying sweets at school).

When you want a treat, use fats. There are recipes for fat bombs on the internet. There are tons of low carb/high fat recipes that taste like a dessert. Eat tons of fat (5 times more than the standard diet allows). Fat keeps you full, makes your skin and hair pretty, feels great on the tongue, is used for the ADEK vits, and helps move the back end issues.

Make sure you are taking your total load of Vitamins every day. Especially D3, which will cut down on your depression.

Find something else to be a treat instead of food. I know it's hard. Been there. Start collecting something, or start buying clothes, or going to the movies once a week. What ever you pick, that is your treat instead of that muffin/donut.

Keep stress eating for now, but change the food. I chomp on carrots, celery, apples, broc, etc. Not only will you cut your calories and carbs way down with this strategy, you will find that you start to disconnect the stress with the sweets. When you stress out, your body nags you to go eat sugar because it releases endorphins (feel good hormones) that acts as "a fix" and you feel better/calmer after eating it (for a little while). So eat as much as you want when stressed, but don't give your body 'the fix' of sugar. You can have protein, or veggies, while stressing - but no carbs. It will be hard for 2 weeks but then gets much easier.

Good luck. You are on the right track.

  • 2 years later...

Watchmeshine8, How are you doing now that it's been a couple of years since this post?

  • 2 weeks later...
LONG POST ALERT- sorry. Please read it, hope it helps.


Aww you sound like my best friends situation, so i’m going to give suggestions just as if i was talking to her. I hope it helps and isn’t to harsh, also feel free to send me a pm if you need to.

1. Plan. Just like how you plan out your school stuff, plan out your meals and your workout schedule. It will help. You can’t eat what you don’t have so if that means you have to pack healthy low carb snacks and order groceries online, then do so.

2. Write things down, whether it’s in my fitness pal, notes section of your phone or an actual food log. Visually see how you eat to hold yourself accountable.

3. Don’t do a “diet” because those are all temporary focus on getting in tons of protein first and you will be to full for junk. Obviously you know to watch your carbs and sugars so no need to repeat that.

4. Meditate- this is mental. Clear your mind and relax

5. Find a workout buddy or coach to help you stay active and even when you aren’t working out, stay busy. Don’t eat in front of the tv, no grazing or snacking, try to stick to 4 smaller meals per day.

6. Therapy- it works wonders and it’s not scary. It will help you overcome the mental aspect of things and help with the self image part of things. Sounds like you’re in the middle of a slight depression, talking to someone can help so much. Many of us (including myself have had to do so)

7. Prioritize- focus strictly on this and school. Worry about men later. Trust me they will always be there, there’s like billions of them on the planet. Date yourself first and do what you love so your confidence improves first. That confidence does NOT come from validation from some guy. You’ll meet the right guy in due time, there’s no rush.

Water- when you think about food always have water first. Then eat later.

Only do workouts you love- this journey truly is 70% diet, 30% exercise. But it is all about 100% consistency. So do things to be consistent. Create a routine for yourself.

You’re soooo driven in all other aspects of your life so i know that you can handle this too. Also realize how far you’ve come. You have lost a ton of weight already and wear that crown proudly!! Tell your self positive affirmations each and every day and practice self care because that is 100% part of self love.


Somewhere in the archives there is a rant from a long time ago, when i first joined that lists a ton of tips i used to mentor my local support group and trust me everything may not be for you, but it will definitely help. Read over it and find what works for you. This is YOUR journey, you’re a strong bad ass and you’re in control of it. Best of luck to you!

Hello, I encourage you to seek out a counselor at your university, usually they are included in your tuition. Also seek your primary care for consultation about medication to manage depression if needed. Taking walks or small breaks during your day will help as well. At lot of what has been posted as been great advice. This will pass and you are getting through it, even if I doesn’t FEEL like it. I remember being this way when I was going through graduate school and working. I actually totaled my car during this time because my mind was so busy! I was truly distracted. I hope thing la change and you become encouraged. Sending hugs and love your way!

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