Still stalled - and hungry. Where's the magic weight loss i was promised?

[James Marusek 5,244]

Congratulations on the 21 pounds that you lost pre-op.

Weight loss post-op will vary by several factors such as type of surgery, and how heavy you were originally prior to surgery.

I had RNY gastric bypass, I lost my weight quickly. I leveled off after about 7 months. Many sleeve patients lose weight at a slower pace but get to the same level of weight loss after 2 years. So the rate of weight loss is a little like mixing apples and oranges between the two procedures.

Also the amount of weight loss will vary by your initial weight. A person in the 400 pound initial range will drop significantly more weight than someone starting at around 200 pounds.

The three most important elements after weight loss surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. Weight loss is achieved through meal volume control.

After my gastric bypass surgery, I was restricted to 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount [3 meals per day] of food, it is next to impossible to meet your Protein daily requirements by food alone, so therefore I had to rely on supplements such as Protein shakes.

I understand that the surgeon's directions on some programs will vary from one doctor to another. But I wonder if the post-op program that you are following might be in part the cause of your slow weight loss. You are eating FIVE MEALS a day. You are consuming 1200 calories a day. [At 8 weeks into the program, I was consuming about half of that amount or less.]

When I look over the directions for patients with gastric sleeve from my surgeon, it reads:

Three 2 ounce full liquid meals for the first four weeks.

Drink 64-80 ounces of Water or low calorie liquids daily.

75-90 grams of protein is required following surgery.

Off hand I think you are consuming too many calories per day even with your extensive exercise program. When I was young, I decided to lose some weight by upping my exercise routine. Over a few weeks I built myself up to 10 miles of walking per day. But instead of losing weight I gained weight. I was replacing my fat cells with muscles and muscles weigh more.

[Christinamo7 4,042]

Oh, I track diligently (and did so for years before the surgery). My nutritionist based my calorie range recommendation on the workout level I did pre-surgery (which I resumed pretty quickly afterwards). I eat 5 small meals, per her recommendations.

when you are a lower BMI, you will loose more slowly. I would be tracking intake and exercise for a few days and speak to your team to ask them what is a good calorie deficit for you. I do not know from your activities if you would be helped with more or less food. some of your hunger feelings say yes you may need more food, or perhaps smaller amounts more often? and some make me think maybe a PPI. so that is certainly something your medical team can help sort out.

that being said, a stall where you are is perfectly normal, and your body is busy with the weight loss process even when the scale doesn't move. the times I can visibly see a difference in the mirror are during stalls.

What do you mean about the PPI? I do take a daily acid reducer (Rx), since surgery. I didn't need one before.

I do track clothing fit/inches and believe me, it's a real stall - I'm not losing inches or gaining muscle. Just stalled. Still in my same, pre-surgery-sized underwear, you know? Ugh.

I understand your frustration then! I have been a slowish looser too - but I do believe at the end of the day slow and steady wins the race. We'll just keep doing what we are supposed to do! looks like you are doing everything just as you should be.

[Hiraeth 515]

I was also going to say that 1200 calories a day seems like a bit much, especially this soon. Ask your doctor if cutting some of those calories would be a good idea.

That's the amount my NUT "prescribed" for me based on my exercise level (which is high). I checked in after surgery and she says to keep doing exactly what I'm doing and by three months they are "pretty sure" I'll see weight loss. But I know most people lose at their highest rate in the first month after surgery. The fact that I've slowed so much already scares me a lot.

The fact that you're feeling actual hunger is odd. Your stomach should be re-designed to only hold a 4 oz meal. Just keep doing what your NUT says. Some people have longer stalls than others. Let us know how things go. <3

[helenpgh 81]

Hang in there. Maybe you are getting hungry because of your high level of activity? I kind of got that you were not excited about having to do such a high level of activity every day like you previously had to do on diets past. If that is true (maybe I misread that) see what happens if you just do an hour a day of fun activity? Think of this as a lifestyle change maybe and try to develop something that you want to live doing the rest of your life. Weight will come off. Different people lose at different rates for various reasons. Your body has just gone through quite a shock and needs time to recover. Be patient with yourself and think about the long game. I know that my first stall lasted a couple of weeks and I was convinced that I was going to be the 'exceptional' case where the surgery didn't work. I am now 12 weeks out and down 40 lbs. and I am 61 yrs old with hypothyroid. I walk around 1 hour per day and do strength training 2 x per week for half hour each. Hang in there!

[NeedaBreak4Me 1,755]

Some of us are just different... i didn't lose much during my first 2 months... its only now during my 3rd that i am finally seeing the numbers drop.

Also, when i had my band, same thing, lost barely anything for the first 3 months.. then dropped a massive amount of weight and reached goal by month 6..

I think us lower BMI patients lose differently than the higher bmi patients... ive noticed mine is slow and steady.. which to be honest i prefer, less loose skin and wobbly bits and skin dimples

[Seastars 175]

I wonder if the post-op program that you are following might be in part the cause of your slow weight loss. You are eating FIVE MEALS a day. You are consuming 1200 calories a day. [At 8 weeks into the program, I was consuming about half of that amount or less.]

When I look over the directions for patients with gastric sleeve from my surgeon, it reads:

Three 2 ounce full liquid meals for the first four weeks.

Drink 64-80 ounces of Water or low calorie liquids daily.

75-90 grams of Protein is required following surgery.

Off hand I think you are consuming too many calories per day even with your extensive exercise program. When I was young, I decided to lose some weight by upping my exercise routine. Over a few weeks I built myself up to 10 miles of walking per day. But instead of losing weight I gained weight. I was replacing my fat cells with muscles and muscles weigh more.

No offense to you and your surgeon's handout, but I need to follow my specific medical provider (dietician's) rules for me in particular. She wants me at minimum 800 but better 1000-1200 calories. She wants 100g (better 125g) Protein given my particular muscle mass, and spread across 5 meals. 125g x 4cal/g is 500 cals just for protein; add in some legumes or the fat in canned fish and I'm at 800 cals easily - without any junk or refined carbs.

[Seastars 175]

Hang in there. Maybe you are getting hungry because of your high level of activity? I kind of got that you were not excited about having to do such a high level of activity every day like you previously had to do on diets past. If that is true (maybe I misread that) see what happens if you just do an hour a day of fun activity? Think of this as a lifestyle change maybe and try to develop something that you want to live doing the rest of your life. Weight will come off. Different people lose at different rates for various reasons. Your body has just gone through quite a shock and needs time to recover. Be patient with yourself and think about the long game. I know that my first stall lasted a couple of weeks and I was convinced that I was going to be the 'exceptional' case where the surgery didn't work. I am now 12 weeks out and down 40 lbs. and I am 61 yrs old with hypothyroid. I walk around 1 hour per day and do strength training 2 x per week for half hour each. Hang in there!

Well, I love SOME daily cardio - and lots more on weekends - as you say, fun stuff like biking or running daily (60-90 min) plus a few hours of hiking on weekends. Depending on the season, I've usually got squash or snowshoeing going on, too. So that's not a lifestyle change - I've always been fit and athletic (just fat, too).

But I dislike being in diet mode where AFTER my usual workout (today: bike-commute, 90 minutes) I need to have another workout in the evening for at least another hour just to burn more calories. And I hate strength training. I know it's good for me, but I hate it. That's the overexercise that makes me miserable (no family time, overuse injuries, disordered thinking/obsession) and I thought I wouldn't have to do post-sleeve.

[Djmohr 6,965]

I hate to say this because I might get boo'd right out of here. LOL

You may actually be exercising too much and eating too much right now. It is a reality that 90% of weight lost post WLS is from diet alone. The other 10% or so from exercise.

You should NOT have to kill yourself with exercise to lose weight. I suspect your diet has too many calories for this early of a stage.

At 4 months post op I had nearly a month long stall. I was exercising an hour a day cardio. I was consuming about 500 calories because that was all I could eat back then. I was told by my surgeon to exercise less (go to 30 minutes per day of cardio) and maybe 15 of my PT exercises. He also told me that I needed to eat more, that is when we raised my intake to around 900 calories of course high Protein lower carb. I have always had a balanced diet post it is what my nutritionist requires.

Anyway within a few days of slowing my exercise and adding some calories the scale began to move again.

With you I think you are actually exercising too much which might be driving some of the idea that your hungry. Honestly you should not feel real hunger post sleeve this early on. That leads me to believe you might have some reflux going on which can cause your exact same symptoms.

Try backing off the exercise a little each day and reduce your calorie intake (check with doctor or nut first), then also ask about reflux and if you need to be taking something for that.

[Djmohr 6,965]

Incidentally I remained on a 900 to 1000 calorie diet until I reached goal. Once I reached goal we bumped me to between 1200 and 1300 calories by adding some whole grains to my diet.

I began maintenance and have been maintaining between 158 and 162 since March.

Just my two cents.....

[Seastars 175]

Some of us are just different... i didn't lose much during my first 2 months... its only now during my 3rd that i am finally seeing the numbers drop.

Also, when i had my band, same thing, lost barely anything for the first 3 months.. then dropped a massive amount of weight and reached goal by month 6..

I think us lower BMI patients lose differently than the higher bmi patients... ive noticed mine is slow and steady.. which to be honest i prefer, less loose skin and wobbly bits and skin dimples

That is GREAT to hear! Around this board and in my support group - and from what my docs advised - I heard just the opposite: that the fastest weight loss happens first, tapering off after 3 and 6 months, until at ~18 months there's not much effect (body used to slower metabolism and sleeve expanded a bit). So I hope, like you, that my weight loss rate will INCREASE soon!

[Seastars 175]

I can't get a dietician appointment for a couple of weeks (I've emailed her with no luck), so eh, you guys have convinced me. I'll eat less- back down to 800 cals, which was working to lose. I'd rather reduce food than add more workouts.

And thank you for the explanation of reflux sounding/feeling like hunger! I do take a daily Rx acid reducer, but once I get a clinic appointment I'll ask if I should increase my dosage. If I could reduce those symptoms, it would be easier not to eat as much.

[NeedaBreak4Me 1,755]

Yes, its frustrating... and at one point i thought.. did i lose half my stomach to stay the same!

But thankfully it has picked up now... i do not know what the numbers are at the moment as i gave up weighing myself cause it was driving me crazy... i decided only to weigh during my follow up appointments.

I also noticed that once i was eating "normally" i started dropping too... and by normally i mean adding salad, veg etc.. so meat/poultry/veg/good carbs etc

[Seastars 175]

My dietician just emailed back. She says:

-stop weighing myself, be patient

"since you have been very active you may need to add an additional mini-meal and add just a little bit of carbohydrates"

So she says I'm not eating enough (maybe). Argghhh!

[pr_pitbullgrl 1,040]

@@Seastars increase your fat. this helped me TREMENDOUSLY. make sure all your carbs are from veggies. no rice, potatoes, Pasta etc. i never even counted anything (im not recommending you stop counting) but eat Protein Protein protein, veggie carbs and NO SUGAR. increase fat.

[Seastars 175]

@@Seastars increase your fat. this helped me TREMENDOUSLY. make sure all your carbs are from veggies. no rice, potatoes, Pasta etc. i never even counted anything (im not recommending you stop counting) but eat Protein Protein protein, veggie carbs and NO SUGAR. increase fat.

Thank you! I had two teaspoons of quinoa today but I promise, usually no grains (or Pasta or potatoes). I usually eat cold-Water fish at least once daily, 2% cottage cheese and sometimes nuts, but that's not a lot of fat. I had a teaspoonful of avocado though today. I will have to brainstorm what I can do to add more fat - maybe eggs.

And yup, no sugar at all! Reduced fruit intake to just a partial serving once or twice a week (I used to eat tons and got pre-diabetes - and obesity - as a result). sugar-free popsicles is my post-surgery go-to. And most Protein shakes and supplements are sweet.