4 months out and FRUSTRATED!!!!!!

[OhioSparkle 9]

Hello- I'm 4 months out RNY. I feel like a failure. I try to talk to my NUT but she isn't helpful. I'm not sure what to do. Hopefully there is someone here that will read this post and help me. I have not lost a single pound in over a month and a half. I'm not sure that I'm doing things right. Can someone show me a sample of their daily plan that includes 1000 calories? I'm starting to wonder if that's why I'm not losing weight, because I'm not eating even close to 500-600 calories. It's hard. A lot of things make me sick.... or I forget to eat because I'm busy 24/7.

[Hrsnjs 267]

Hello- I'm 4 months out RNY. I feel like a failure. I try to talk to my NUT but she isn't helpful. I'm not sure what to do. Hopefully there is someone here that will read this post and help me. I have not lost a single pound in over a month and a half. I'm not sure that I'm doing things right. Can someone show me a sample of their daily plan that includes 1000 calories? I'm starting to wonder if that's why I'm not losing weight, because I'm not eating even close to 500-600 calories. It's hard. A lot of things make me sick.... or I forget to eat because I'm busy 24/7.

I has VSG but my issue is the opposite. They want me at 600 calories a day but I have trouble staying under 800-850 and still get all my Protein. Have you looked at adding in Protein Shakes to boost calories between meals...like while you're busy and can't stop to eat slowly and mindfully? Good luck with this.

Sent from my Pixel 3 using BariatricPal mobile app

[James Marusek 5,244]

OhioSparkle - you indicated that you had RNY gastric bypass but posted this in the sleeve section. The following response is provided assuming you are RNY:

The three most important elements after RNY gastric bypass 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 after surgery through meal volume control. You begin at 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 of food, it is next to impossible to meet your protein daily requirements by food alone, so therefore you need to rely on supplements such as Protein Shakes.

So I would recommend you first verify that you are meeting your daily protein, fluid and vitamin requirements.

Some members on this board have noted that for RNY gastric bypass surgery, they have entered a stall by eating too little. That may be what is happening in your case. When you eat too little it throws your body into a starvation mode and your body holds onto every calorie as if it is their last - thus no weight loss. So make sure that you are following your daily meal plan volume. You must eat the recommended amount. Also the meal plan is based on volume not calories. If you are looking at calories make sure you are including your protein shakes into the calorie numbers.

If eating causes nausea, it may be due to a complication such as a stricture or an ulcer.

The transition to solid foods can be difficult on your stomach. I found softer foods such as chili and Soups went down much easier than harder foods such as steak and chicken. Therefore I relied on these to a great extend. I provided some recipes at the end of the following article.

http://www.breadandbutterscience.com/Surgery.pdf

[GreenTealael 24,847]

Can you provide your daily menu/schedule/routine so we can help you troubleshoot? Also include all liquids and amounts.

Also what was the exact advice of your team?

[Frustr8 7,886]

Thank you James, I did download it, know you were talking to @ Ohio Sparkle but I see much there I also can use.Especially the chili, bet one could use ground turkey, chicken or even pork if one of the other meats more tolerable.
This morning I am once again nauseous but we already know I am strictured and moderated. Taking things easy on my tummy, regressed temporarily to plain liquids but will try not to become fluid-poor and dehydrated on top of things. Best of the day to you and yours!

[Frustr8 7,886]

ulcerated, nothing moderate in that!

[FancyChristine15 810]

It will be easier if you can tell us what your intake is like: food, Water, calories burned/exercise, etc.. That way, we can assess and offer advice.

[KimTriesRNY 1,853]

I can give you a vague menu.

For Breakfast I usually eat eggs and maybe some chicken sausage. Sometimes one of those prepared mini omelettes. On a rare occasion I have low sugar oatmeal. Calories are usually 250.

For dinner I usually eat a meal of chicken, pork, fish, or some type of Soup that is high in Protein. Calories are usually 250-300.

I normally eat Snacks of Greek yogurt , certain Protein Bars, maybe some pistachios, cottage cheese, or lunch meat. I average 800-900 calories a day but I try to eat more on days I’m in the gym or more active.

It is tough as I miss some vegetables and need to find more balance of working them in but I just cannot eat a lot. I get about 75 grams of protein and less than 50 grams of carbs a day currently.

[SteveT74 359]

I am a sleeve, not a bypass--but my surgical uses the same post-op diet plan for both procedures, with only minor differences in terms of supplementation. It's really hard to look at one person's macro and diet and use that as a basis to determine what's best for you. We all have our own issues and challenges to deal with. We also all have issues with stalls, although I agree that a month and a half is on the long side. The fact is, however, you started off at 311 when you had surgery in late August 2018 and you're now down to 235 as of today. Since you've been stalled for one and half months, that means you lost 75 pounds in a 4 month period. That's a LOT of weight in a very short period of time. Shorter than I think is common. Maybe a long stall isn't entirely unusual in these circumstances. That said, if you're eating less than 600 calories a day 5 months out of surgery, that seems really low. I am just finishing up my soft/puree phase and I am consuming between 700 and 900 calories per day. I expect that to go up to 1200 calories or so per day over the course of this year--maybe even 1500.

I have been essentially following my doctor's guidelines, which means eating three meals per day that cause me to consume at least 70g of Protein per day. I am also drinking more than 64oz of Fluid per day, which maybe one of the most critical ingredients to weight loss. While my post-diet (at least for this phase of my recovery) doesn't limit me in terms of macronutrients (provided I hit my protein goals), I have chosen to limit myself to 20g or less of net carbs (which does not count Fiber or sugar alcohols consumed). I have also chosen to eat only foods that have good quality sources of fat--like avocado, fish (and fish oils) etc. As a result, I have put myself in a state of ketosis, which seems be really helping me make the most out of my sleeve (at least for now). I would NOT say that I am following a Keto diet, since more than 50% of my food intake is coming from protein and maybe 35-40% is coming from fat, with less than 10% coming from carbs (it varies day to day, but carbs are always under 20g). I am also trying to exercise daily--not just take a walk, but really work up a good sweat and get my heart rate of to 80% max. I am not suggesting you do what I am doing--everyone needs to find their own best path--but if you're in a prolonged stall it's best to change things up. If I were in your shows, I would try hard to get in more protein and fats (to the extent you can tolerate them) and get your calories up closer to a 800 a day. I get that you might not be able to eat the fat at this point depending your sensitivity to dumping, but you can't continue doing the same thing that isn't working for you at the moment. You need to change a couple of things up to restart your weight loss engine. If that means drinking an extra Protein Shake or getting in an extra little meal to reach a new calorie/protein goal, then do it. See how it goes for a couple of weeks.

Also, if your nutritionist isn't helpful, is there another bariatric nutritionist you could speak to???