I had gastric sleeve surgery 11/9/2016. I am 5' 4.5" and weighed 245 on the day of surgery.

Fast forward nearly 10 months, I'm down 37#. I have fluctuated between 35 and 40 pounds for the past 5 months. I'm sick with disappointment. I thought this would be easier. I cashed out nearly all of my 401K to pay for this surgery because my insurance wouldn't cover it.

What is wrong with me? Am I doomed to be fat forever?? I thought the purpose of WLS was to make it easier to lose weight.

Can someone share experiences that helped you get back on track? What is a typical daily menu for you?

What do you eat in a day?

Hi,

Thank you so much for replying to my thread. Please don't scream, but I'm not consistently eating low carb/sugar but I'm a heck of a lot better than I was a year ago.

Mornings/Breakfast: 1 cup 2% Fairlife milk, with sugar free Nestle Breakfast essentials chocolate powder, 1 cup coffee. This makes my own latte-ish drink. An order of Sous Vide egg bites (egg white and red pepper) from Starbucks (170 cal).

Lunch: Frozen entree with at least 15g protein but fewer than 10g of sugar.

Snack: greek yogurt with fewer than 10g of sugar or starbucks frappe

Dinner: whatever the family eats...last night it was spaghetti.

Because of the size of my stomach, I can't eat as much as I used to so I really don't understand why I'm not losing more.

Cut out the processed foods, they have lots of salt which will make you retain water. You may not be getting enough of the good carbs. How's your water intake and exercise?

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Cutting out processed things will be tough but certainly not impossible. Can you recommend a eating plan to stick to?

Atkins?

Paleo?

I do the keyto diet, pretty easy.

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Cut out the frappe, but you knew that.

Go back to the protein first, veggies if there's room. Some people can also do some other complex carbs (whole grains and such) some can't.

If your weight hasn't budged in 5 months, then it sounds like you have reached your new set point. Going forward, weight loss will be similar to preop. Try not to fret, since you still have your sleeve to help you

From the numbers, your ideal weight is 100lbs less than your surgery weight. (Important question.. did you lose weight right before surgery? If you did, that impacts what I say next).

To be considered a medical success, you need to have lost 50% of excess weight within 18 months postop. So that would be 50lbs. Having only lost 37 this far.. if you don't lose more, then surgery DID fail you.

So let's try to get over this hump, and make it a success story. (The good news is that 208 IS a lot better than 245, so at least there's that.)

Step 1. Go back to basics. Try to prepare as much of your food at home from single-ingredient items as you can. Fast foods and processed foods are how many of us gained weight to begin with. I believe there are hunger-inducing additives in many of the products.

Step 2. Make sure you stay up on your medical stuff. If you have low thyroid levels it can cause problems with weight loss, etc.

Step 3. Count and measure everything. Try to stay around 1000-1100 calories a day, 60g protein, lots of water. Exercise will help at this point. No added sugar and no white flour (getting rid of those two things will basically knock most processed foods off the "ok" list).

Example meal plan:

Breakfast: 4oz cottage cheese and 4oz blueberries

Lunch: 1 egg (cooked how you like) and 3oz pinto beans and 2T salsa

Snack: 1oz peanut butter on celery

Dinner: 3-4oz hamburger patty with 1/2 cup green beans or canned spinach.

Calorie free beverages only.

On 9/5/2017 at 10:51 AM, stpatty said:

Hi,

Thank you so much for replying to my thread. Please don't scream, but I'm not consistently eating low carb/sugar but I'm a heck of a lot better than I was a year ago.

Mornings/Breakfast: 1 cup 2% Fairlife milk, with sugar free Nestle Breakfast essentials chocolate powder, 1 cup coffee. This makes my own latte-ish drink. An order of Sous Vide egg bites (egg white and red pepper) from Starbucks (170 cal).

Lunch: Frozen entree with at least 15g Protein but fewer than 10g of sugar.

Snack: greek yogurt with fewer than 10g of sugar or starbucks frappe

Dinner: whatever the family eats...last night it was spaghetti.

Because of the size of my stomach, I can't eat as much as I used to so I really don't understand why I'm not losing more.

I'm not going to scream but your food choices are terrible. I eat Sous Vide Egg bites when I am out because they are easy, and I am usually low on calories but I am also, basically at goal. The egg white version while lower in calories is a worse choice than the bacon and gruyere version because it is higher in carbs. The carbs are exactly equal to the protein. The bacon and cheese version the protein out numbers the carbs 2 to 1. So if you need a Starbucks breakfast because, that is what is easy, get black coffee and the Bacon and Cheese version. If the egg bites aren't worth having black coffee, then don't get them.

That morning drink you are making is also bad. Why not just have coffee? Or have coffee and 2 tablespoons of half and half? Half and half is only 40 calories. A cup of milk is 120. Yeah you are getting protein but it is coming with 6 grams of sugar. The "sugar free" breakfast essentials, has 12 carbs, 7 of which are sugar. Drinking that you are having 18 grams of carbs for 18 grams of protein. You could have a premier shake, less calories, more protein, less sugar.

The frozen entree at lunch, just stop that. Either go out and get a burger and don't eat the bun. Bring just lunch meat, get a sandwich and just eat the meat. There are a ton of better options. I used to get Italian beef from the sandwich shop by the office and have them put it in a bowl for me with cheese. All protein and and a little fat from the cheese, and low calorie.

The snack with the yogurt or the frappe. Replace that with protein. Lunch meat, grilled chicken cut into strips, quest protein chips, a protein bar, anything but what you are eating.

Dinner, Just eat protein and when you finish your protein eat a Veggie.

Your calories are high and so are your carbs so you are not losing.

Until you get to goal, you can't eat normal just in smaller portions. You will not lose like that. People also regain eating just like that. Eventually you are going to stop being stalled and just start regaining.

Plus you don't really seem like you are logging or tracking. How much spaghetti did you have? Did you portion it and weigh it on a scale first? With enough sauce it is just slider and you can eat a lot of it.

If you really want to lose, you are going to have to change your food choices and tighten up your habits. You can do it, you just have to choose to.

Cut out dairy and flour based products. You will see results. You are worth it.

If your weight hasn't budged in 5 months, then it sounds like you have reached your new set point. Going forward, weight loss will be similar to preop. Try not to fret, since you still have your sleeve to help you [emoji4]
From the numbers, your ideal weight is 100lbs less than your surgery weight. (Important question.. did you lose weight right before surgery? If you did, that impacts what I say next).
To be considered a medical success, you need to have lost 50% of excess weight within 18 months postop. So that would be 50lbs. Having only lost 37 this far.. if you don't lose more, then surgery DID fail you.
So let's try to get over this hump, and make it a success story. (The good news is that 208 IS a lot better than 245, so at least there's that.)
Step 1. Go back to basics. Try to prepare as much of your food at home from single-ingredient items as you can. Fast foods and processed foods are how many of us gained weight to begin with. I believe there are hunger-inducing additives in many of the products.
Step 2. Make sure you stay up on your medical stuff. If you have low thyroid levels it can cause problems with weight loss, etc.
Step 3. Count and measure everything. Try to stay around 1000-1100 calories a day, 60g protein, lots of water. Exercise will help at this point. No added sugar and no white flour (getting rid of those two things will basically knock most processed foods off the "ok" list).
Example meal plan:
Breakfast: 4oz cottage cheese and 4oz blueberries
Lunch: 1 egg (cooked how you like) and 3oz pinto beans and 2T salsa
Snack: 1oz peanut butter on celery
Dinner: 3-4oz hamburger patty with 1/2 cup green beans or canned spinach.
Calorie free beverages only.

Care to elaborate on the following:
“...If your weight hasn't budged in 5 months, then it sounds like you have reached your new set point...”

and

“...(Important question.. did you lose weight right before surgery? If you did, that impacts what I say next).
To be considered a medical success, you need to have lost 50% of excess weight within 18 months postop. So that would be 50lbs. Having only lost 37 this far.. if you don't lose more, then surgery DID fail you...”

I mean read so many people ‘s weight stall at first few weeks or months aft operation even they are following exactly wat was told.
How to speed up weight loss right aft operation?

If you have say "please don't scream" then you know exactly what you are doing wrong. So fix it. It's that simple. Follow your diet and let your yes mean yes and no mean no when it comes to food. Don't make it complicated.

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12 hours ago, izzit2017 said:

Care to elaborate on the following:
“...If your weight hasn't budged in 5 months, then it sounds like you have reached your new set point...”

and

“...(Important question.. did you lose weight right before surgery? If you did, that impacts what I say next).
To be considered a medical success, you need to have lost 50% of excess weight within 18 months postop. So that would be 50lbs. Having only lost 37 this far.. if you don't lose more, then surgery DID fail you...”

I mean read so many people ‘s weight stall at first few weeks or months aft operation even they are following exactly wat was told.
How to speed up weight loss right aft operation?

It's funny reading something I wrote only a couple months ago, and I would say something a bit different now.

You are right.. the losses preop have little to do with the success/failure of the surgery. I think I was going to say that the losses preop could predict the RATE of loss postop. Oops, my bad.

There is a line of thinking that the surgery will lower our "set points". This is a theory, there is no real way to test it. If our set points are lowered, then our bodies stop constantly trying to regain the weight... thus the losses after surgery tend to be durable.

My original response was basically saying, hey, the surgery moved your set point only so much, now it will be much harder to lose.

I think I've had a new epiphany over the last several weeks. I now think the surgery works because of the caloric restriction it permits. I'm sure there are lots of chemical/hormonal/metabolic changes as well, but those are things that we, as patients, can't control or interact directly with. So there is no point in talking about them in stall/regain posts.

The thing that causes fat loss is consuming fewer calories than we burn. It's easy to eat very few calories for the first 6 months postop. But, then our stomachs relax, we can eat more, and hunger comes back. Calories can increase, weight loss slows, then stops.

And we wonder why we haven't reached goal.

If this is true, then "set point" only means the weight that an individual carries based on their average daily intake (in relation to their metabolic rate).

So, if you want to lose more weight, you have to eat fewer calories. It's as simple as that. The trick is to still feel like you've eaten while minimizing calories. This means eating whole, unprocessed foods that have a lot of bulk and nutrition for relatively few calories.

I think my epiphany came when reading posts from patients that had surgery, then immediately were consuming maintenance-level calories (1500-2000). They didn't lose any weight. If the surgery does something really special, it wouldn't matter how many calories we ate, we'd still lose.

Ok, so with all of that.. those people that are eating very few calories and are stalling early in the process have something else going on. Their bodies are retaining fluid. I don't know why we retain fluid (there are theories), but we do... and we can hold onto it for a couple weeks, then it'll leave with a "flush", sometimes 5lbs overnight.

The way to tell if you're just hanging onto fluid is if the scale stays the same but your clothes get looser. Also, if you are eating fewer than 1000 calories a day, I can pretty much guarantee it's fluid.

The only way I know to limit these fluid-retaining stalls is to eat more calories and exercise less. The body is less stressed and doesn't retain as much. BUT, you might be setting yourself up for poor overall losses if you do it this way.

Personally, I've eaten an average of 1100 calories since 8 weeks postop (I'm almost 8 months out now), and haven't exercised, and haven't really stalled. But, I also am not losing as quickly as someone that eats 800 calories and goes to the gym. (And since I'm not at goal yet, I can't say whether I'll even get there, or how maintenance will be. I do plan to start exercising for strength and fitness though).

Thanks! Greatly appreciate your explaination, very enlightening indeed

Another thing to note....

As we lose weight, we need fewer calories just for subsistence. Phrased another way, a 300lb body burns more calories just existing than a 100lb body.

If you consistently eat, say 1000 calories a day, you may lose 3-4lbs a week at the start. Eating the SAME calories three months later when you weigh 50lbs less your weight loss will slow.

On 9/5/2017 at 10:51 AM, stpatty said:

Because of the size of my stomach, I can't eat as much as I used to so I really don't understand why I'm not losing more.

I agree with what the majority have stated on this post. You will have to train yourself to realize that just because you can only eat a small amount of food, it does not equal weight loss. I have heard of many people gaining their weight back because of poor food choices, even though they were eating them in small amounts. But eat enough of them everyday and you body starts storing the fat. I am finally back on solid foods and have found that my grocery shopping and cooking has been simplified in a good way. I buy only what I need to make it through the week or till my paycheck and then when I cook it is only meat and veggies. So if you are cooking spaghetti for the family, make some turkey or chicken meatballs to go with it that you can eat and add a multi veggie salad. That way the only thing you are "missing out" on is the pasta.