I need some advice from some bariatric veterans out there...I am almost 4 weeks out and worry that I'm already doing this wrong.

I've been following my NUT's instructions, and am on the soft food stage (scrambled eggs, purees, tuna, yogurt, etc). She told me to continue doing the Protein shakes (60-80g daily) and incorporate two or three 2-4 tbsp meals in addition to this. She did not mention the amount of calories I should be getting daily.

Well. I worry because it's already about 400 with the Protein Shakes (sometimes more if I use almond or skim milk), and then adding the small meals per day I am nearing 700 calories daily, and a lot of things I've read and heard is to try and stay between 300-600 calories per day. And this is at the very minimum amount of food, so I worry I'm already messing up!

So my question is, what calorie range should I be within at this point, and how do people get all their protein without going over?

(Some of the meals I make are 1 scrambled egg, salsa and cheese with a tiny bit of avocado mushed in / tuna and hardboiled egg with mustard and paprika / oikos triple zero greek yogurt / tilapia and mushed cauliflower)

What sort of daily meals do you guys do?

***ALSO, as it gets further down the road, say 6 months+, how many tablespoons or ounces of food would you say you eat in a meal? I'm just hoping to get a frame of reference THANKS!!

Edited April 14, 201610 yr by swizzle

I was around 400-500 at that time, but my shakes were less calories than yours. Every nut and doctor I have spoken too agrees that the more calories you can get in, especially in the beginning when your body is taxed by surgery the most, the better! I think you're doing just fine. Especially since most of your calories are in liquid form. I honestly wouldn't worry about it at all. 700-800 calories was the goal that was given to me and I was nowhere near it.

Edited April 15, 201610 yr by Cervidae

Okay that makes me feel a bit better. What protein shakes do you recommend? I usually use Unjury or Syntrax and they are about 100calories per scoop.

And thank you!

I've pretty much always stuck with premier protein. 160 a shake, three shakes a day, and I would be at 480 cals a day. Getting those three and as much water as I could took literally my entire day, and even sitting on my butt doing no physical activity, that was not enough calories to sustain me. Even now, 700 calories is not enough to sustain me. I can function but I'm exhausted and my muscles tire quickly. You're still taking in way less than you're body needs, which is why we lose so quickly. We're burning our surplus.

I stopped protein shakes around a month in. My dietician wanted me getting protein in via food. Lucky because I was sick of the shakes after the pre op phase lol

The most important things after surgery are meeting your Protein, Fluid and Vitamin daily requirements. Meals are secondary because your body is converting stored fat into the energy that drives your body. Thus you lose weight. Exercise is also important. Weight loss after RNY surgery is driven by meal volume control rather than caloric restriction. This article describes my experience with RNY gastric bypass surgery during the "Weight Loss" phase. There are recipes at the end. http://www.breadandbutterscience.com/Surgery.pdf

It's strange that you were not given meal volume limits as a function of weeks/months post-op prior to surgery. My guidelines started me out at 4 tablespoons (1/4 cup or 2 ounces) per meal for the first 8 weeks following surgery and slowly increased that to 16 tablespoons (1 cup or 8 ounces) at 1 1/2 years post-op. At 4-6 month post-op, my meals were limited to 8 tablespoons (1/2 cup or 4 ounces) per meal.

@Cervidae : My doc said that the Premiere Protein shakes were good but that we should only count them for half the protein as is listed on the nutritional information, because it was something about the fact that they (and things like Muscle Milk) are concentrate, and bypass patients won't be able to break it down as well. Otherwise those are wonderful!

@James Marusek : my NUT did give me volume recommendations 2-4 tbsp for this first month, but didn't give any calorie recommendations. Maybe it's just not that important in this phase? Thanks for those recipes!

@@swizzle

Congratulations on a terrific start! I had a very long discussion with my nut about premier Protein shakes mostly because someone else brought up the same issue you mentioned.

My nut recommended Premier Protein for me.

When I told her that I was told we could not absorb all of the protein in one shake she actually pulled out a diagram that showed exactly where different nutritional elements are absorbed. While it is true that Calcium is malabsorbed, it is not true about protein. Calcium as well as other Vitamins are absorbed in a different part of the digestive system. A 30gram Protein Shake will have no problem. That has been validated with all of my post op labs completed in the last 19 months.

I am at goal and premier protein is the only shake I drink once per day. I get the rest from food.

I also had this conversation with my surgeon because I was worried and wanted a second opinion. I wish I would have taj

Ken a copy of that document but it was the only one she had and it had personal notes written all over it.

The other thing I would add is that you don't need to even worry about calories at this stage. Just focus on Water and Protein and take your Vitamins. By 8 weeks I was no more than 1/4 cup of food (think about that measurement as already chewed up food.

At the one year mark I really started to focus on calories because your volume will go up and by this stage you are trying different things. I am at the stage where I can eat about a cup of food unless it is a really dense protein and then it is less. Or a salad I might get in 1 1/2 to 2 cups depending on the protein I add.

I am 19 months post op and reached goal in March. I am trying to increase calories and it is difficult for me. I currently range between 900 and 1200 per day. 70 grams protein, less than 100 grams carbs.

@Djmohr Thank you! That's awesome news! I really can't stand having to use the shaker and the potential for the clumps. I've had the Premier Protein and it's delicious! I think I'll give that a go for a while since it seems to work for so many people!

Also thanks about the heads up for the calories. I think I'm just going to chill out and not worry about it and just follow what my NUT said. It's working, obviously, but I just was worrying myself about it so I am just going to step back and take a deep breath and keep on keeping on

Great job at getting to goal! I can't WAIT!!! :)

PS: I JUST remembered that today is officially my one monthaversary! Down 32lbs since surgery date! Ridiculous!!!

Edited April 15, 201610 yr by swizzle