I had my operation 3 weeks ago, an RNY bypass, and weighed this morning. To date I have lost 3 pounds. That loss includes the fasting before surgery and the day of 1 cup of yogurt only, plus the day I tried a scrambled egg and ended up blocking my pouch and not eating all day.

A low BMI patient with a starting weight of 187.3 (at 5'4" my BMI was 32), I already had a very controlled caloric diet, eating only 900-1200 calories per day and essentially low carb. I was slowly gaining weight on that which is why I opted for the surgery. When the nutritionist went over my post-op diet I told her it was the same number of calories I was already eating but she had no reply to that. Some of the items I was to eat daily were things I would never have had before my surgery, such as toast, jam, and mashed potatoes.

I also still have a large lump a couple of inches below (internally, down in my belly) the hematoma which remains where my drain was placed, and basically no energy.

I am upset and very frustrated especially when I think of what I've put my body through and the expense, only for no results other than scars and lumps. Does anyone have any suggestions?

I had my operation 3 weeks ago, an RNY bypass, and weighed this morning. To date I have lost 3 pounds. That loss includes the fasting before surgery and the day of 1 cup of yogurt only, plus the day I tried a scrambled egg and ended up blocking my pouch and not eating all day.

A low BMI patient with a starting weight of 187.3 (at 5'4" my BMI was 32), I already had a very controlled caloric diet, eating only 900-1200 calories per day and essentially low carb. I was slowly gaining weight on that which is why I opted for the surgery. When the nutritionist went over my post-op diet I told her it was the same number of calories I was already eating but she had no reply to that. Some of the items I was to eat daily were things I would never have had before my surgery, such as toast, jam, and mashed potatoes.

I also still have a large lump a couple of inches below (internally, down in my belly) the hematoma which remains where my drain was placed, and basically no energy.

I am upset and very frustrated especially when I think of what I've put my body through and the expense, only for no results other than scars and lumps. Does anyone have any suggestions?

None of us lose at a constant or steady rate. We all experience stalls and slow downs. Almost everyone experiences a stall about three weeks after surgery.

Since you already started at a very low weight/BMI you probably won't see a dramatic initial weight loss.

Nowhere in your post do you mention Fluid or Protein. It sounds like you have mostly been eating carbs. What is your protein target? Until you are able to get enough fluid and protein you probably will have low energy. Both are absolutely critical for healing and weight loss. The number of calories is less important than the soy cow of those calories. 1000 calories of mashed potatoes, toast, and jam, have absolutely no protein.

You just had major surgery and your body needs time and nutrition, mostly protein, to heal.

You need to follow your program.

Track your food.

Focus on getting at least 64 oz of fluid.

Make sure you are reaching your protein target. Mine is 100 grams a day. Try to aim for at least 80 grams if possible based on my surgeon's guidelines for someone at your starting BMI.

Avoid starches, added sugars (especially high fructose corn syrup), and fried foods.

Take your Vitamins and supplements as directed.

Exercise when cleared.

Stay off the scale if you are going to let the numbers drive you crazy.

And, Embrace the Stall

http://BariatricPal.com/index.php?/topic/351046-Embrace-the-Stall

I wish it were that simple but I am not 'stalled', I am gaining weight. I misspoke above and am only 2 weeks out of surgery, not 3. I am following exactly the diet the nutritionist gave me, but your point about Protein is a good one. I've been eating salmon for protein, and sugar free yogurt, but still have several days to go before I can begin to add things to my diet. The nutritionist seemed more concerned about malnurishment than weight loss and though I was told to have protein, I was given no target amounts. For years I have tracked my foods and weight and I have never eaten much in the way of starches, sugar, or fried foods and haven't started in the 2 weeks since my surgery. In fact, having had 1 day of terrible pain and vomiting since my attempt at a scrambled egg gave me a blockage, I am scared to eat much at all and am very careful not to overeat.

The three most important daily requirements after RNY gastric bypass surgery is to meet your Protein, Fluid and Vitamin requirements. food is secondary because your body is converting stored fat into the energy that drives your body.

Generally when patients are in the hospital for surgery, they gain weight because they fill your body with fluids. So you must first lose that weight before you see any major loss. Also during the first few weeks after surgery, your body is in a major heal mode.

Weight loss after surgery is achieved through meal volume control, not necessarily through limiting your calories. So follow the requirements of the program for the meal volume. It should be about 2 ounces per meal in the beginning, which is incredibly small. Therefore you will need to supplement this with a protein supplement such as several Protein shakes per day.

So meet your daily requirements for protein, fluids and Vitamins, walk 30 minutes per day (or equivalent exercise) and stick to the program requirements for meal volume and then let the magic happen.

Thanks James,
That was helpful. One of the reasons I had this surgery is that for the past 8 months I have had a foot problem which has left me unable to walk much, in fact walking (which i used to do a lot) makes my foot incredibly worse.

My portion control was already good before the surgery - I was amazed that I could eat so little and still be gaining weight, and the surgery has not changed that. The only real issue I had with eating is that I am taken out to eat so much that I was taking in too much food on the weekends, and I do think the surgery will help with that as now feel no desire to overeat.

I haven't tried Protein shakes as i am allergic to nickel and react to many preprepared foods, plus the idea of a chemical shake just seems unhealthy, but it seems I should give those a try. It seems odd to me to add food in the form of a Protein Shake since I am eating so little to begin with and still gaining weight?

Muse

And a response to Inner Surfer Girl. I AM FOLLOWING MY PROGRAM and still gaining weight. That is the ENTIRE POINT of my post.

And a response to Inner Surfer Girl. I AM FOLLOWING MY PROGRAM and still gaining weight. That is the ENTIRE POINT of my post.

And my point is until you are able to get in all of your Protein and fluids, then the numbers on the scale mean NOTHING. Seriously, stay off the scale, eat protein, and drink fluids.

All of the carbs you are eating are going to restore what was depleted from your liver. You NEED protein to heal and to lose weight.

Healing is your primary goal, or should be, right now. The weight loss will come.

Thanks InnerSurferGirl. I'll try to keep things in perspective and drink Protein shakes. You are certainly right that I am still healing and I don't feel particularly good.

Thanks InnerSurferGirl. I'll try to keep things in perspective and drink protein shakes. You are certainly right that I am still healing and I don't feel particularly good.

It gets better. Fluids and protein will go a long way in helping you bounce back. You will get through this.

I would be frustrated too. The first few weeks are very challenging. I started my journey with a BMI of 46.8 at 5'2". At my 6 week meeting with surgeon my BMI is 36.9. At this BMI, he said he wouldn't have qualified me for surgery. I was given a goal of 60g of Protein a day (or do my best). I also was on pureed foods for first two weeks, NO scrambled eggs. I realize every Surgeon has their own program for patients to follow. I did not have a drain. I am 3 mos post RNY. Keep following the program and doing what Surgeon advises.

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I started out at 3 Protein shakes a day after surgery. As my meal volume increase, I concentrated on eating high protein meals and as a result was able to reduce this down to 2 per day, then 1 per day and at a year and a half, to completely take myself off Protein Shakes. But in the beginning you need to supplement your protein, otherwise your body will pull stored protein from your muscles *such as your heart muscle", your hair (which will begin to fall out) and you will loose all your energy. And that is not good. I used Muscle Milk Light (vanilla Creme) powder blended with Water and a half a banana. I used a Ninja blender with a single serving cup to blend it. You do not have to like the Protein shake only tolerate it. There are many, many choices out there on protein shakes. I became lactose intolerant after surgery so I could not drink milk (which is a good source of protein), so I had to pick a type that was lactose free and blend it with water. If you have other food allergies, you may have to select one based on your personal needs.

This article describes the approach I used after surgery. http://www.breadandbutterscience.com/Surgery.pdf

Thanks all,

You were right, it was just a stall. After that week I started dropping pretty regularly, an ounce or two per day, sometimes more. Thanks too for the advice about Protein. I am pleased that I can tolerate milk just fine (yay!) and fresh fruits too. The biggest issue I'm having now is dumping, and it is odd. I am not (nor could I tolerate) eating sugar or much in the way of carbs, but still experience frequent dumping. This morning I ate one scrambled egg with cheese and spent the next hour plus in misery. The only thing I can tie at all to the dumping is drinking with meals, which I'm doing my best to stop. Anyone else experience this?

No drinking 30 minutes before, and Atleast 30 minutes after... I can't drink for more than an hour after I eat anything dense.

Are you dumping, or are things getting stuck?

I've also heard that eggs are an 'iffy' choice frest out of surgery... that some people do fine on them, and other's have issues with them. Maybe that's it?

I am post RNY nearly two years and still cannot eat eggs without getting sick. It is the only thing that makes me sick.

Keep pushing the Protein and fluids with no sweeteners and you will continue to lose weight.

Drinking with your meals at all is a huge NO NO for RNY. If you drink you can push food through too quickly possibly causing a blockage and certainly flushing food before you even get the nutrients and causing you to be hungry. This is one of the most important rules and it really is for life.

You have to get a handle on that.

One way to do that is to ensure that you start your day well hydrated. I have learned to drink at least a 20 oz bottle of Water first thing in the morning. Then I wait, drink 1 protein shake that gives me a 30gr boost of protein. Then I wait at least 30 minutes and drink another 20 to 40 ounces of water. If I do that I find that I am not thirsty at all when I eat my meals. I wait at least 30 minutes before eating and in the beginning it is important that your protein is moist and my nut has always had me eating lots of veggies and fruit. She taught me that 2 bites of dense protein for every 1 bite of fruit and veggies. In the beginning I measured everything and I still track what I eat in my fitness pal. I have since learned to trust my tummy to tell me when I am full.

If you follow these simple rules, you will lose the weight.

@@AmusedMuse I have had similar feelings since surgery, especially when read posts where people share that they are losing 30+ pounds a month. I am 7 weeks post-op an am losing about 3 pounds a week - no loss for weeks 6 to 7. I met with my surgeon last week and shared that while I was sticking strictly to the plan, I wasn't losing as rapidly as I thought I would. He explained that people starting at lower BMI would lose at a slower rate and that he thought I was doing great. I am glad that I had that discussion with him as it made losing no weight this past week much easier to handle!

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@MsMiniMe

I see that Dr Weiner is your surgeon. That is so cool. I have seen all his videos on YouTube & will be starting the Pound of Cure diet when my surgeon gives me the green light. (I'm only POD #9.) I like what Djmohr says about fruits & vegetables, not to forget about beans!