1 month post op. Shocked by nutritionist’s recommendations. Anyone else?

[Creekimp13 5,838]

This description of the dangers of Very Low Calorie Diets (VLCD) from the University of Michigan describes some of the metabolic issues that are associated with sustained diets under 1000 calories a day.

https://www.uofmhealth.org/health-library/aa144561

(from the above link)

The following are the changes your body goes through during a VLCD:

• Your metabolism slows to conserve energy because the body thinks it is starving. A slower metabolism burns fewer calories.
• To get the carbohydrate it needs, your body breaks down protein. You lose lean body tissues (muscle and organ tissue). It is important to preserve lean tissue, because it increases your basal metabolic rate. Losing too much lean tissue increases the percentage of fat in your body. The result is a reduced metabolism. This is one reason why it is so easy to regain weight after you lose weight quickly.
• In a VLCD (or during starvation), about half the weight you lose is fat and the other half is lean tissue, such as muscle. On a more moderate diet, you lose 3 times more fat than lean tissue. It is important to preserve lean tissue, since it increases your resting metabolic rate.
• Mineral and electrolyte imbalances can occur. These imbalances can be life-threatening. This is the reason these VLCDs must only be used under a health professional's supervision.
• Bone mass is lost. This is more risky for women, because they diet more often than men, and they are also at higher risk for osteoporosis.

[summerset 5,261]

10 hours ago, LaoDaBeirut said:

One thing I think is an actual problem within the WLS surgery community is all the bragging about how little someone can eat. I've seen it a lot but not so much on this site. Someone will say what they are eating and other people chime in with oh I can't eat that much or I cant have 1,000 calories that's too much.

This.

It's like a weird competition. For many patients it also seems to be very pleasing that circumstances are the complete opposite of what they once were.

---

Not being able to stop eating -> not being able to eat more

Not being able to stop gaining weight -> passing their goal weight and still losing

People telling them to lose weight -> people telling them they should stop losing weight

Struggling with eating less -> struggling with eating more

Only being able to shop at certain stores because of needing big sizes -> having problems finding really small sizes

---

It's like many patients are taking a morbid pride in this and simply love the humble bragging. Like things being the complete opposite of what they once were is some kind of wonderful badge of honor. People still love to engage in the extremes - just different extremes.

Maybe the worst thing about this is that too many patients seem to think that they're actually engaging in "healthy behavior" when going to extremes.

[summerset 5,261]

14 hours ago, Creekimp13 said:

I have not seen the study, but I was told by my doctor that people who eat more calories sooner will lose weight slower, BUT....statistically have much less regain later....the hypothosis being....this is because the metabolic set point is being re-estabilshed at a more robust livable caloric level.

And maybe fewer patients are suffering from dieting burnout as well.