Post. Op 20+ years

[SanDiego Girl 3]

HW 333 LW 170 CW 220

Surgery date was 6/2000

i am 21 yrs out and a daily exerciser. My step are always over 10k a day. Very active. My pouch has stretched for sure. In July 2020 I had a stomach ablation done where they go down the throat and zap the pouch to try to create some scar tissue to try to shrink the pouch to give you a feeling of fullness as if he just had surgery. I was on liquids for two weeks and lost 12 pounds. I went crazy not having solid foods. I’ve gained six of those pounds back over the holidays. I’m currently sitting in about 221 I want to be at least 180. My biggest challenge is I can’t seem to stick to any food plan. After the ablation the doctor had me doing 800 g of fruits and vegetables a day. No he’s a gastroenterologist and he supposed to know that we are to eat Protein first. He disagrees. I’m in a major metro of San Diego so it’s not like he’s a fly-by-night doctor. About 10 years ago I had a metabolism study done at Scripps hospital in la Jolla and they said metabolism had really slowed and my resting metabolism was about 1486 cal a day. I’m not sure what that equates to but they said I should eat under 1200 cal a day. I’m just really struggling getting this weight off I keep starting the five day restart pouch thing and then I’ll eat pizza… chocolate seems to be in the mix every night. I am extremely frustrated and can’t seem to get any of this weight off on my own. About five years out from my by pass I turned alcohol and became an alcoholic. That was crazy! I am 8 yrs sober and 59 yrs old! Help please! I wish I could get the surgery all over again !

[ms.sss 14,637]

Some questions:

1) How tall are you?

2) Does your daily exercise include more than 10K steps a day?

3) Do you know how many calories you consume daily? (on average)

4) When you had the metabolism study done 10 yrs ago, do you know how much you weighed a the time?

Edited January 31, 2021 by ms.sss

[catwoman7 10,846]

I wouldn't do the pouch test again. Most nutritionists hate it because it's too much of a restriction, which for many people will just end up setting them up for a binge. Just start logging your food again and see how many calories you're averaging a day (may have to do this for a couple of weeks to get an average). Then once you know your average, start cutting back - slowly - by about 100 calories each time (maybe once every two weeks) until you start losing. Gradually getting down to 1200 a day (or whatever you need to for losing) should be easier than dropping 500 - or 600 - or whatever - calories overnight.

[SanDiego Girl 3]

I am 5'6' and I Jazzercise 6 days a week which is 35 min of cardio and 20 minutes of weights and toning. Here is a typical day

Brkfst - Fairlife Protein Shake

snack - tangerine

lunch - 230 salad

snack - nuts and string cheese or Protein shake

Starbuck skinny Carmel Machiatto

dinner ; meat and Veggies - Soup or Tacos - Zoodles and turkey spagetti sause

snack - Skinny cow and 5 dove dark chocolates.

My metabolism study I weighed 233. They put on Contrave and then I was on a low dose of Bufrofren and something else that made my hair fall out. I got down over 3 yrs to 195.

I'm so tired of working so hard to be overweight. My Doc wants to do an ablation again. I'm really at a loss.

[ms.sss 14,637]

@SanDiego Girl :

Ok, first the disclaimers:

Disclaimer 1: I am not a medical professional/nutritionist...just an avid reader/googler.

Disclaimer 2: The values below are very generalized and assumes that you have more or less an average metabolism, average functioning insulin regulation, average body fat percentage for your stats, etc. etc.

TL;DR: If you want to skip my very long-winded dissertation below, the gist of my message is this: you may want re-evaluate your calorie consumption-activity level combo, cut the sugar, and manage your expectations.

Now, your weight today is pretty much what it was when you had your metabolism study, so let's assume you still have a BMR of 1486.

This means that if you all you did all day was sit like a statue and breathe, then you would burn 1486 cals for just existing.

Your reported exercise can be classified as "Moderately Active" (30-60 mins of sustained elevated heart rate sessions 4-6 times a week). Add this to the regular activity of every day living (i.e., just moving), and your daily caloric needs would be approximately 2150 cals a day to MAINTAIN YOUR WEIGHT. To lose weight, you will need to consume under this amount (or up your activity levels)

CALORIES

Without knowing exactly what's in your lunch salad, nor what consists of your meat/veggies dinner, nor what amount of each, I calculated the you are probably consuming about 1750 calories (I arbitrarily assigned 300 & 400 for each of lunch and dinner).

This means, using the oft-used statistic that a deficit (or gain) of 3500 cal results in a 1lb loss (or gain) of body weight, you theoretically should be losing on average 0.8 lbs a week. This assumes that you NEVER go over 1750 cals a day, and you sustain your current activity level. Based on your original post, it sounds like you aren't. **Note that this is not an exact science, and I personally think 3500=1lb is an overly simplistic assumption, but for the purposes of this post, lets just keep it simple. I digress...**

Soooo....if you would like to lose a bit more, a bit faster, try cutting your current cals by a couple hundred (your teams suggestion to aiming for 1200 is sound in this case). Your reported typical daily menu above includes 880 cals of JUST SNACKS. Perhaps try cutting out the Starbucks and 1/2 the nightly Dove chocolates. Doing this alone will save you 245 calories a day.

SUGAR

Another more controversial suggestion would be to cut all (or drastically reduce) sugar/sweeteners. Not only is sugar poor nutritionally, excess amounts causes spikes in glucose levels, which may to lead insulin resistance: which means the cells in your body aren't as efficient at removing glucose in the blood, so it will store it as fat. Which is weight gain.

Further, it is theorized that sugar begets sugar. When you are eating it, you want more. So if you can white knuckle it for a few days and get it out of your system, it is suggested that you will find that your sugar cravings will subside.

EXPECTATIONS

Lets say you keep your cal level at 1750 & moderate activity levels (and do not deviate from it). This still means you would theoretically still be losing 0.8 lbs a week. This also means you would reach your 180 goal in 50 weeks. Are you ok with this timeline? Can you sustain at most 1750 cals a day for 50 weeks? If you go above this level you will extend that timeline accordingly. Edited to add: remember that this 1750 max cal level will reduce as YOU reduce!

You are quite a ways out of surgery and unfortunately don't have the extra tailwind that recently sleeved people have. Its very easy to get frustrated and give up when your hard effort results in what is perceived as slow weight loss. The typical manifestation of this frustration is to eat (and usually its like pizza or Cookies and NOT carrots and yogourt). If you can figure out how to deal with the frustration for just longer periods of time (I mean no one actually expects this to be completely solved immediately by sheer will), you will already be a couple steps up in the game.

Good Luck! ❤️

P.S. Am really sorry that this was so long.

P.P.S I think its worth noting here again in the postscript the Disclaimers noted above:

Disclaimer 1: I am not a medical professional/nutritionist...just an avid reader/googler.

Disclaimer 2: The values below (sic) are very generalized and assumes that you have more or less an average metabolism, average functioning insulin regulation, average body fat percentage for your stats, etc. etc.

Edited February 1, 2021 by ms.sss

[catwoman7 10,846]

You got an A on that dissertation, ms.sss!

[ms.sss 14,637]

35 minutes ago, catwoman7 said:

You got an A on that dissertation, ms.sss!

Just an A, teach? Can we schedule an appt during your office hours to discuss?

😂😂😂😂😂😂😂

[20years 0]

I will hit 20 years this May and it’s been a roller coaster. I have weighted as much as 160 and as little as 110. But it’s a long way from my original weight of 254. I try to eat healthy but occasionally binge and then pay by dumping.
Does anyone else still get the sweats and dizziness after eating sweets?

[catwoman7 10,846]

3 minutes ago, 20years said:

I will hit 20 years this May and it’s been a roller coaster. I have weighted as much as 160 and as little as 110. But it’s a long way from my original weight of 254. I try to eat healthy but occasionally binge and then pay by dumping.
Does anyone else still get the sweats and dizziness after eating sweets?

yes. It's probably reactive hypoglycemia (RH), which isn't that uncommon among RNYers. It usually appears when you're a year or two out. I have to eat something every 3-4 hours and limit my sugar intake. If I eat a carb, I have to eat a Protein with it. As long as I follow these "rules", I rarely have the problem

oh - if you're getting sweats and dizziness right away after eating, it's more likely dumping. If it's an hour or two later, it's most likely RH.

[ms.sss 14,637]

4 hours ago, 20years said:

Does anyone else still get the sweats and dizziness after eating sweets?

I do. But I’m only 2.5 years out. Its a little better than before, but definitely still around (dumping)

(oh, and I’m a sleeve)