Gaining a Couple of Pounds Between Doctor's Appts During Pre-Surgery Phase

[FluffyChix 17,409]

Have any of you gained a pound or two or four between one doctor's visit to the other? Were you kicked out the program?

My surgeon has me adding calories to bring my pre-surgery diet up from around 600cals (which I set) to 1000cals. Now she said I need to be eating 1500 cals/day--that 1000cals/day was still too stingy for pre-surgery calories. On my second visit, I'd lost 19lbs in the 6 weeks since she last saw me and am approaching being under 40bmi. I'd worked up from 600cals to 1000cals. Now I'm up to 1200cals and I've gained 4 lbs back. The last thing she said to me was not to gain weight. I'm like, "Well duh! I told you the first time that a 1200cal/day diet makes me gain weight." So do I continue to work up to her 1500cal diet and show her what happens with my weight? Or do I go back to eating around 850cals/day and get this excess weight off while I still have time to lose back to my weight level at the last appointment?

(P.S. I really don't want to call her office about this if I don't have to.)

TIA!

Edited September 20, 2017 by FluffyChix

[Introversion 1,876]

I'm embarrassed to admit I gained 25 pounds between the initial consultation appointment (October 2014) and the month of surgery (April 2015).

The weight gain was due to food funerals, a.k.a. eating my favorite foods one last time before saying "goodbye." I also couldn't control my ravenous appetite.

Luckily, my surgeon and insurance company were very lenient and didn't care whether I gained or lost weight during the pre-op phase as long as my BMI remained greater than 35.

[FluffyChix 17,409]

@Introversion Thank you for sharing this! Cuz one thing that I want to really illustrate is that I CAN lose weight--if I go below 900cals/day. But how can anyone (especially with a non-altered tummy) eat this way for the long term without losing focus and will power? Cuz I will admit this is white knuckle dieting in the extreme! I deal with head and real hunger all. the. time. (Ironically, it's gotten worse with more calories!) And I've got half a mind to do my 1500cals and report in with the gain and illustrate that I've been telling the truth the whole time. However, I would hate to be kicked out of the program just for illustrating a point to my surgeon!

Someone (won't say who) cautioned me that being too successful losing in the pre-surgery stage makes the insurance people say that if you are this successful, then why do you need weight loss surgery? And it's a valid point. I've always been able to lose if I cut cals/fat low enough. But I've never been able to sustain that caloric/carb restricted level, nor achieve maintenance levels. And when I finally become exhausted with it all and move up--even a few hundred cals (like 300-400 cals/day), I gain it all back like an avalanche.

[Joann454 1,329]

[mention=317167]Introversion[/mention] Thank you for sharing this! Cuz one thing that I want to really illustrate is that I CAN lose weight--if I go below 900cals/day. But how can anyone (especially with a non-altered tummy) eat this way for the long term without losing focus and will power? Cuz I will admit this is white knuckle dieting in the extreme! I deal with head and real hunger all. the. time. (Ironically, it's gotten worse with more calories!) And I've got half a mind to do my 1500cals and report in with the gain and illustrate that I've been telling the truth the whole time. However, I would hate to be kicked out of the program just for illustrating a point to my surgeon!
Someone (won't say who) cautioned me that being too successful losing in the pre-surgery stage makes the insurance people say that if you are this successful, then why do you need weight loss surgery? And it's a valid point. I've always been able to lose if I cut cals/fat low enough. But I've never been able to sustain that caloric/carb restricted level, nor achieve maintenance levels. And when I finally become exhausted with it all and move up--even a few hundred cals (like 300-400 cals/day), I gain it all back like an avalanche.

Most of us could lose weight but keeping it off is a whole lot different. Lose the weight the dr wants you to. If you're working with a team they should know the insurance ins and outs. I was told not to go below 230 before surgery. The team was very aware of my insurance guidelines. Shoot them an email and ask what is the lowest you can go for insurance purposes. Definitely don't "prove a point" by doing the 1500 kcal diet. You don't want to ruin any chance you have.
To your original question. I was all over the place with my weight at my weigh ins. I did lose the initial weight they wanted me to by surgery though. They read me the riot act at my second to last weigh in. I ended up dropping 15 lbs in two weeks after that and they were happy! God I hated that whole phase! You'll be glad when it's in the rear view mirror too.

[FluffyChix 17,409]

1 minute ago, Joann454 said:

Most of us could lose weight but keeping it off is a whole lot different. Lose the weight the dr wants you to. If you're working with a team they should know the insurance ins and outs. I was told not to go below 230 before surgery. The team was very aware of my insurance guidelines. Shoot them an email and ask what is the lowest you can go for insurance purposes. Definitely don't "prove a point" by doing the 1500 kcal diet. You don't want to ruin any chance you have.
To your original question. I was all over the place with my weight at my weigh ins. I did lose the initial weight they wanted me to by surgery though. They read me the riot act at my second to last weigh in. I ended up dropping 15 lbs in two weeks after that and they were happy! God I hated that whole phase! You'll be glad when it's in the rear view mirror too.

Yeah, 230lbs is the magic threshold that takes me out of the 40bmi zone--which I don't want to risk doing. But dayum. How on earth do I "maintain" between 230 and 240 when I'm already there. If I could maintain, I wouldn't need the surgery. Right? So frustrating. On top of that, my insurance is diff now and they may require 6 months instead of 3. So I'm maybe looking at March before I qualify. How do I maintain within such a tight (for me) window for the next 4 months? Just whining. Sorry y'all. I've just been working and starving myself to death since May to lose about 50 pounds only to learn that I could get penalized for starving myself into doing too well. You know?

[DropWt4Life 957]

FluffyChix, I don't know what the answer is. Insurance companies should be mandated to accept the initial doctor's appointment as your weigh in for consideration or at the very least the date that they put you on a diet. You shouldn't be able to lose too much weight. I really believe that this is the reason for making you be on a supervised diet for 6 months. You drop below the threshold and they are off the hook.

So dumb. I think that 1-2 months on a supervised diet is more than enough. You should be advised on the correct way to eat, and given a chance to apply it. If they feel that this time is not enough for you, then don't penalize you for success. I would just continue eating as you are, but just up the calorie count a bit since you said that you are starving yourself. Maybe eat larger portions of the same foods. You appear to be losing really fast. This would slow that down. I would never try to get someone to try to slow their weight loss, but you might not have a choice.

I would then down a few large glasses of Water and eat something before each scheduled weigh-in until my last!

Man, I'm such a cheater!

[Apple203 1,314]

Bummer, Fluffy. I am 1/3 way thru and I don't even know if I am expected to lose weight pre-surgery! My first dr appt is tomorrow.

[shedo82773 1,236]

Isn't it funny how each Dr and different insurance all can't be on the same page? I was pretty lucky because I had some of my Preop test done. But the DR that was going thru only wanted to do a Lap Band on me. Was not going to work for me because my hubby had nothing but problems with his. So I went to another Surgeon and when he started finding all of my test done it went fairly fast. But I did have to do 2 weeks on Protein Drinks and then 4 weeks Postop. He never told me to lose any amount of weight, I guess I was one of the lucky ones. Like was said above I think you should go back to a number of calories that you will lose the weight on. Like was said it would be horrible if you couldn't get your WLS because you gained too much. Good Luck on your journey. Keep us up on what happens.

[Newme17 3,444]

I don't recall if I gained anything or even lost anything. My initial weight is what the insurance company went with, so it wouldn't have mattered to gain or lose. Obviously, the doctor and team wanted a loss. So anyway, you're absolutely right...going such a low cal diet is NOT sustainable for anyone. I agree with @DropWt4Life, give yourself back some cals. If you'd really like to see how much you're supposed to be eating to maintain the weight you're at now, find a few online calculators to give you an average of calories needed.

[sassy683 184]

my initial weight was 253 ... I gained 3lbs (256) then my second to last nut appt I lost 7lbs (249) then I was told to gain at least 3lbs back so now im at 252 and I have one more appt with my PCP to clear me for surgery and then my pre-op starts on Oct 3rd and that's when I meet with the surgeon again before my actual surgery on Oct 19th

[The Reducer 12]

Don't sweat it. My first visit i weighed in at 390 and the surgeon told me I'd have to be 389 or less by my surgery date 6 months later. I had a serious case of last supper syndrome and ate my way to a 20 pound gain in 3 months. Each time I saw my surgeon during those months, he said, "not good man. You're going the wrong way". I finally got serious about a month before my surgery date and slid in at 389 at my final pre-op appt. As of today, (my surgery was 9/7) i am down 50 pounds! Although, today in particular, I would sell a kidney for a cheeseburger and fries having had nothing but liquids for 5 weeks now. Hoping that feeling subsides soon!

[FluffyChix 17,409]

44 minutes ago, The Reducer said:

Don't sweat it. My first visit i weighed in at 390 and the surgeon told me I'd have to be 389 or less by my surgery date 6 months later. I had a serious case of last supper syndrome and ate my way to a 20 pound gain in 3 months. Each time I saw my surgeon during those months, he said, "not good man. You're going the wrong way". I finally got serious about a month before my surgery date and slid in at 389 at my final pre-op appt. As of today, (my surgery was 9/7) i am down 50 pounds! Although, today in particular, I would sell a kidney for a cheeseburger and fries having had nothing but liquids for 5 weeks now. Hoping that feeling subsides soon!

Oh wow! Congrats on your success and surgery!!!

(Pssst, so cheeseburger with fries on a liquid diet...are you allowed cream Soups? I'd make a cheeseburger (grilled) and a couple of oven roasted potato squares (from a small potato). Simmer it all of it in beef broth until it's really flavorful. Then strain the broth and drink it, or else, puree it and thin it down with beef broth until it is basically "cream". ) You'll be on solids before you know it!

[hmills653 365]

Oh wow! Congrats on your success and surgery!!!
(Pssst, so cheeseburger with fries on a liquid diet...are you allowed cream Soups? I'd make a cheeseburger (grilled) and a couple of oven roasted potato squares (from a small potato). Simmer it all of it in beef broth until it's really flavorful. Then strain the broth and drink it, or else, puree it and thin it down with beef broth until it is basically "cream". [emoji4] ) You'll be on solids before you know it!

I tried to puree a hamburger and it was disgusting lol.

[FluffyChix 17,409]

@hmills653 Yeah, I agree, it sounds pretty obnoxious! I would rather just grill the burger meat and simmer it in the broth. Then strain it and drink the thin broth. It will still taste like burger, but will be broth. Best of both worlds. Right?

[ReadyforChangeChan 35]

My insurance didnt care about weight gain between appts but between your initial weight and final weight before submitting you could not show a gain-ie no net gain. Be sure you know what your ins stance is. Aetna is who i have and they would have denied coverage.