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Keto Diet with weight loss surgery - What are your thoughts about it?



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I do modified keto - cut out all sugary and starchy carbs (sugar, rice, potato, bread etc) but eat whatever fruit and veggies and legumes I like. So, not really true keto but keto-ish. Facing said that, I've just started the Jan challenge and want to keep my net carbs under 50 a day so that means no fruit most likely.

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Posted (edited)
On 12/14/2018 at 4:31 AM, Swanton_Bomb said:

I get really confused about this. I understand that being in ketosis means you are burning fat for fuel, but isn't the bottom line calories in, calories out? I am in ketosis by default now because I am early out and just can't eat much of anything, so even with no real attempt to avoid carbs, I have very few grams of them. If someone ate 500 calories of carbs or 500 calories of Protein and fat, wouldn't they lose with both?

So CICO (calories in/calories out) isn't a purely valid concept according to the biochemistry. But let's pretend it's close enough for government work. Ok?

In theory (and this is from one of the leading Keto docs who trained under Dr. A.) keto IS putting our body in fat burning state rather than being a sugar burner. There is between a 200-400calorie advantage for doing that because it takes more energy to convert energy from protein/fat than it does to burn sugar. But still..that's sorta insignificant.

What keto is great at is making your feel energetic so you move more! (This is after you get past the 2 week keto flu.) Also, it's a great appetite suppressant. So the deeper into ketosis you are (ie the more ketones you are burning for fuel), the lower your hunger. AND the fewer your cravings (lower your head hunger). So by defacto, you DO end up eating less. And he said, that's what they want you to do! They want you to naturally moderate and reduce your calories!

So it really isn't a "free for all" food fest. It's only EVER been intended for people to eat just to the point where hunger is abated, but not to fullness. Sound familiar? Sounds a little like our weight loss surgery rules. Yes? This is part of why I think WLS + Keto/Low Carb = Match Made In Heaven. Why not reduce your hunger as you eat healthy healthy and take in as few calories as you can without the pain of hunger?

Edited by FluffyChix

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I did Keto last year and lost 30lbs and felt great! Took a cruise and of course totally bombed Keto so I thought I get back on when we got home. I tried never really got back into it. I ended up gained 45 lbs back and got a kidney stone from the diet because I only have 1 kidney and I should have never done the diet. It works but only if you are going to stick with it. From my experience please make sure the diet is safe for you!
Once I got sleeved I am watching my carbs but I am not getting into Ketosis! Good Luck!

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2 minutes ago, MistyRS said:

Once I got sleeved I am watching my carbs but I am not getting into Ketosis! Good Luck!

It looks like you have lost 22 lbs in less than a month. Since ketosis is your body using fat stores for energy, it would appear that you are in ketosis, to me.

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Posted (edited)

I am not in Ketosis. All my Jell-O and popsicles have sugar in them and I was eating cream of potato Soup just to make sure I stayed out of it. I drink a strawberry Snapple everyday as well and have since surgery. Also I should say I have left over Keto Strip that you pee on just to make sure!

Edited by MistyRS

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44 minutes ago, MistyRS said:

I am not in Ketosis. All my Jell-O and popsicles have sugar in them and I was eating cream of potato Soup just to make sure I stayed out of it. I drink a strawberry Snapple everyday as well and have since surgery.

Even if you are consuming sugar/carbs, you are not consuming enough to keep yourself out of ketosis. By definition ketosis is "When the body does not have enough glucose for energy, it burns stored fats instead",

So you maybe feeding your body foods that convert into glucose, but it is not sufficient, so your body is using your fat stores as well, hence your 22 lb loss in less than a month.

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Posted (edited)
On 11/30/2018 at 8:44 AM, FluffyChix said:

I don't call myself "keto" although I am not only by virtue of low carb dieting, but also cuz of low calorie diet. I'm in dietary ketosis (aka producing ketones and using ketones/fat for fuel).

I have issues with the high fat of the current keto model, so I do a more moderate fat diet. My numbers are more: 30% P, 55% F, 15% C (or for 850cals I get: 64g Protein; 52g Fat; 32g Carbs (total, which nets to around 20g from veg etc).

It sure works for me. I also IF to further reduce insulin resistance and assist with fat loss and autophagy.

Do you use a blood meter to check your ketone level by chance? I'm curious what hardcore ketosis looks like post-op vs. pre-op just eating keto. Currently I keep my ketones at about 1.7 - 2.0 mmol and it is VERY hard to keep this up. To measure blood ketones I have a KetoMojo meter.

Edited by Kimmie K

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I'm not "hard core". LOL, see? I said so in that statement. I don't claim "keto". I am LC. We just got one for Christmas but I haven't wanted to blow into it until I'm sure I'm over my cold. Those levels are very hard to maintain.

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Posted (edited)
14 minutes ago, FluffyChix said:

I'm not "hard core". LOL, see? I said so in that statement. I don't claim "keto". I am LC. We just got one for Christmas but I haven't wanted to blow into it until I'm sure I'm over my cold. Those levels are very hard to maintain.

Meh, potato/potatoe...you're in ketosis, it's measurable. In order to be in ketosis you simply have to eat less that 20-50g (high side) of carbs a day AND avoid sugar, which it seems bypass patients do naturally (unless you still manage to pound back Cheetos and soda lol). No one will crank out ketones by eating that junk.

I'm curious what level of ketosis bypass patients have achieved by not actually trying, just following a low carb diet, like you. Most folks tend to cut sugar anyway to avoid dumping so the minimal amount consumed by a post-op person eating by the book most likely isn't enough to knock you out of ketosis, if so, not for long. See what I mean? To me, someone with bypass, eating as they should, should easily be able to achieve "hardcore" nutritional, if not near therapeutic, ketosis just by barely eating bad carbs or sugar.

Edited by Kimmie K

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12 minutes ago, FluffyChix said:

I'm not "hard core". LOL, see? I said so in that statement. I don't claim "keto". I am LC. We just got one for Christmas but I haven't wanted to blow into it until I'm sure I'm over my cold. Those levels are very hard to maintain.

Girl, once you get better give that thing a whirl! FOR SCIENCE! :D

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9 minutes ago, Kimmie K said:

In order to be in ketosis you simply have to eat less that 20-50g (high side) of carbs a day AND avoid sugar

But one can achieve ketosis by consuming very low calories, not at all dependent on the source of said calories

If I were to eat 100 g of pure carbs a day, and nothing else, that would be 400 calories. My BMR is around 1300 calories. With that large of a calorie deficit my body is forced to use fat stores for energy, and I would therefore be in ketosis.

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Hey guys, I am joining this Keto party. I just had my vsg done on 12/17 and I was just approved for solid foods this week. My surgeons starts his patients on purees/softs immediately upon discharge, so I was pretty much eating a low carb high Protein diet from day 2 post surgery. The post-op diet was close enough to Keto or OG Atkins, that I decided to get on the Keto train (particularly after my first stall). Honestly, I think it's putting my weight loss into turbo boost. I am hitting all of my hydration and protein goals with ease, with the balance of my calories coming in the form of healthy fats like avocado, extra-virgin olive oil, fish oils, ghee etc. I have cut out all vegetable oils, canola oils and products made with these. I am not eating any processed foods. I don't technically have a true Keto macro because I can't possibly eat enough calories to get my protein in and have 70% of my calories come from fat. What I am able to do though is use the 800-100 calories I can consume in a day to get to 55% protein, 40% fat and 5% carbs. My net carbs are always under 20g at the end of the day. I did go through the keto flu, which lasted about 3 or so crappy days. It was worth it though--because the weight is pouring off at a prodigious pace. In fact, my surgeon thought my one month follow up was my two month follow up because he was looking at my numbers and lost track of the surgery date!!! So, I am going to credit a good half of my weight loss to following a keto style diet.

It may be a little different you guys with bypasses, but keto and VSG go together like Peanut Butter and jelly. Although I needed to lose 80 pounds, I started on this WLS journey because I was diagnosed with T2DM last year. I am sure VSG is really helping me with the T2DM, but what I noticed is that once I started following a keto style diet, my blood sugar stopped spiking after meals. I used to get spikes into the 180's, now 40-60 minutes after eating, my blood sugar may go up to 115 or 120. I used to wake up with BG levels at 140-160. After surgery and following the standard diet, that dropped down into 115-125. Now adding in the keto-style diet, my waking BG levels are now between 72 and 95 every morning!!!! I am no longer taking any meds for my T2DM.

In addition to the VSG and keto-style diet, I have significantly upped my exercise levels. I am at the gym 5am every morning for spin class, elliptical machine or treadmill. Now, I am adding in weight training. I get about 2 hours of serious exercise every day. I work out in a fasted state (no Breakfast before my workout) and I feel great. Loads of energy. Studies have shown that doing cardio in the morning in a fasted state burns 20% more fat that doing the same cardio workout after a meal. The same may not hold true for weight training... so maybe a Protein Shake before or immediately after the weight training part of my workout??? I still need to fine tune this.

As for keto sticks, I know some have poo pooed them. However, they are a good indicator to tell you if you're in ketosis in the very beginning of the diet. After you are fat adjusted to the keto way of life, you won't/shouldn't be seeing any ketosis by-products in your urine. If you're using the sticks, it doesn't matter how pink or purple they turn. If you're showing any ketones in your urine (well, it not really ketones, but a related compound), you're in ketosis. You're either in ketosis or your not (it's like you can't be a little bit pregnant). I personally wouldn't spend the $50 or $60 to buy a blood test--after a few weeks, you can just tell when you're in ketosis. I have knocked myself out a couple of times by eating too much protein to quickly (protein shake) or by making a dietary mistake (hummus), but once you have been in a consistent state of ketosis, it's not hard to get back in. You do it by dieting and, if you work out hard, you'll deplete your glycogen stores quickly and that will put you right back into to ketosis.

Also, if the reason you're knocked out of ketosis is because you ate too much protein, that's not really the end of the world as far as I am concerned. Protein can be converted to glycogen through a process called gluconeogenesis; however, this is not an easy process for your body to do and requires a lot of energy. Even at rest, your body will burn at least 20% more energy to convert protein into glycogen than it would carbohydrates--so it's not an efficient process. It's easier to convert fat into ketones, once your body is fat adjusted. Either way, you're buring more calories and will be a net winner in terms of weight loss.

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@SteveT74 You're my kinda dude! You have this keto thing down! Way to go! You're right though...from my time on here and hearing what other have to say, I sounds like eating true keto with bypass might be harder to pull off considering the diet requires you eat high fat and moderate Protein. Who knows though? I think if you can eat at least eat a 1:1 fat/protein ratio you'll be good. I sure as heck will try when the time comes! You're also right about pee sticks. They're worthless. If you're peeing out ketones, your body isn't using them for energy. Also, if you're dehydrated you will pee ketones so they're not reliable at all. When it comes to measuring what your body is creating itself and using for energy, it's going to be blood ketones. Pee sticks may be good for diabetics or something, but if you're going to eat a true ketonian diet, get a KetoMojo meter to test your blood. It's an excellent investment and easy to use. We need to keep in touch :)

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On 1/18/2019 at 4:42 PM, 🅺🅸🅼🅼🅸🅴🅺 said:

@SteveT74 You're my kinda dude! You have this keto thing down! Way to go! You're right though...from my time on here and hearing what other have to say, I sounds like eating true keto with bypass might be harder to pull off considering the diet requires you eat high fat and moderate Protein. Who knows though? I think if you can eat at least eat a 1:1 fat/protein ratio you'll be good. I sure as heck will try when the time comes! You're also right about pee sticks. They're worthless. If you're peeing out ketones, your body isn't using them for energy. Also, if you're dehydrated you will pee ketones so they're not reliable at all. When it comes to measuring what your body is creating itself and using for energy, it's going to be blood ketones. Pee sticks may be good for diabetics or something, but if you're going to eat a true ketonian diet, get a KetoMojo meter to test your blood. It's an excellent investment and easy to use. We need to keep in touch :)

I wouldn't call my diet a true therapeutic keto diet, since I am basically doing 1:1 fat to Protein. I would call it more of a keto inspired diet. :) It's the best I can do keto, while I am limited to about 1000-1200 calories a day at this point. Since I still have to get around 120-150g of protein to meet my daily needs (since I am working out a lot), I just can't eat enough fat and still stick to my calorie goals (and I don't want to go too high on calories this early post-op). Nevertheless, I am still in ketosis, but I get kicked out if I have too much protein in one meal. Since I am hitting my protein goals daily, I do try to prime the pump by eating some good fats first (like avocado) before I eat my protein.

As for keto sticks, they aren't the most reliable tests, but if you're in your first month to 6 weeks of a very low carb diet (20 or less grams), they are helpful in letting you know if you're in ketosis. However, if you get a reading on them doesn't show acetate (which is a by product of ketosis) in your urine, that doesn't mean you're not in ketosis--so, in the sense they aren't reliable. Of course, they are only reliable in the beginning. Once you become fat adapted, you shouldn't have any acetate in your urine. The blood test is obviously the most accurate way to check, but I am just not up for spending $60 bucks for a blood meter kit and just 10 test strips, since the test strips are so freakin' expensive. The keto sticks are good enough for my purpose and there are plenty of physical signs that you're in ketosis after the 6 week mark anyway.

Frankly, with or without a ketogenetic diet most early bariatric patients are going to be in ketosis anyway because they are consuming barely any calories. A ketogenetic diet essentially stimulates the benefits of a fast, without having to actually fast (although you would want to mix in intermittent fasting with keto if you want to maximize losses---if you are NOT a bariatric patient or are more than a year post-op). Also, even you are a bypass patient, you can still do keto--but you have to start a little differently by phasing in fats over the course of a few weeks rather than making sudden transition which a non-bariatric patient might do. There are plenty of resources online for bariatric patients (including bypass patients) that would like to transition to a keto diet.

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2 hours ago, SteveT74 said:

I wouldn't call my diet a true therapeutic keto diet, since I am basically doing 1:1 fat to Protein. I would call it more of a keto inspired diet. :) It's the best I can do keto, while I am limited to about 1000-1200 calories a day at this point. Since I still have to get around 120-150g of Protein to meet my daily needs (since I am working out a lot), I just can't eat enough fat and still stick to my calorie goals (and I don't want to go too high on calories this early post-op). Nevertheless, I am still in ketosis, but I get kicked out if I have too much protein in one meal. Since I am hitting my protein goals daily, I do try to prime the pump by eating some good fats first (like avocado) before I eat my protein.

As for keto sticks, they aren't the most reliable tests, but if you're in your first month to 6 weeks of a very low carb diet (20 or less grams), they are helpful in letting you know if you're in ketosis. However, if you get a reading on them doesn't show acetate (which is a by product of ketosis) in your urine, that doesn't mean you're not in ketosis--so, in the sense they aren't reliable. Of course, they are only reliable in the beginning. Once you become fat adapted, you shouldn't have any acetate in your urine. The blood test is obviously the most accurate way to check, but I am just not up for spending $60 bucks for a blood meter kit and just 10 test strips, since the test strips are so freakin' expensive. The keto sticks are good enough for my purpose and there are plenty of physical signs that you're in ketosis after the 6 week mark anyway.

Frankly, with or without a ketogenetic diet most early bariatric patients are going to be in ketosis anyway because they are consuming barely any calories. A ketogenetic diet essentially stimulates the benefits of a fast, without having to actually fast (although you would want to mix in intermittent fasting with keto if you want to maximize losses---if you are NOT a bariatric patient or are more than a year post-op). Also, even you are a bypass patient, you can still do keto--but you have to start a little differently by phasing in fats over the course of a few weeks rather than making sudden transition which a non-bariatric patient might do. There are plenty of resources online for bariatric patients (including bypass patients) that would like to transition to a keto diet.

Well said! And yes, you can totally do keto without a meter. I generally can tell when my ketones are above 1.2+...you get that "buzz". Ya know what I mean? It's an energy that you can feel from the top of your head to the bottom of your feet. It's a great feeling. Mainly bought a meter because I'm a big fan of experimenting. Sounds like you're doing an awesome job! Keto on, man!

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