Short version:

I'm 45 yo, 6'3", 275. Pre-surgery eight years ago, I was about 440. Weight has plateaued for the last 15 months, whether I eat well or carelessly. A dietitian has recommended that I need significantly more calories and protein than I've been getting, but I'm having a very difficult time getting close to her recommendations though I'm constantly eating throughout the day, while still stopping when I start to get full. Having a very hard time exercising because of debilitating back pain.

My questions:

1) What's your opinion on the dietitian's recommendations of 2,700 cal and 220g of protein per day?

2) How do you all (especially guys) get enough calories and protein given our small stomachs?

3) Are there any good resources for long-term post-sleeve eating plans? All I can seem to find on here and elsewhere are focused on the weeks and months after surgery.

Long version/background:

I'm 7.5 years post-gastric sleeve, and am currently at 275 lbs., close to my lowest post-surgery weight of 267. (I'm 45 years old and 6'3", with, my doctors and massage therapists tell me, a very large, wide frame.) In the nine months to a year after my surgery, I got down to 285, then plateaued there for a while. I have spent most of my time since between 290 and 305, once getting up to 330. In 2017, I nearly died from a massive, undiagnosed liver infection, and after my three-week hospital stay, I was down to 267. I was back up to 310 in Jan. 2019, and since then a year-long progress to 270, and I've been between 270-280 for the last 15 months or so.

During those 15 months, I have had a couple of months-long periods of being very careful and planned, logging food and staying under 2,200 calories and over 100g of protein per day. I have also had a couple of extended stretches of not being as careful eating—consuming more junk calories, but being pretty consistent not over-eating and stopping when I'm full.

I was confused as to why my weight stayed the same no matter what I did, so I consulted a regular dietitian, someone who is not focused on bariatric patients, but who has worked with several before me.

Her opinion was that I wasn't getting enough calories, that I should be aiming for 2,700 calories per day, with macros of 220g protein, 200g carbs, and 110g fats.

I have tried doing this, but am finding it very, very difficult to hit those marks. To get even close while stopping when I start to get full, it seems like I am eating all day long every couple of hours.

(One more note: I have been getting little to no exercise mainly because of debilitating back pain (from degenerative disc disease and arthritis) that just keeps getting worse and does not respond to any medications or treatments. Hydrocodone, which I'm not taking currently, does nothing, I feel zero effects from it, like they were placebos. Nerve ablation made it worse, and one highly respected back surgeon says all I can do is lose weight.)

Edited April 10, 20215 yr by GSVguy
typo

I feel like you need a dietitian for our specific bariatric surgery need. I’m only 4 weeks out and I can’t fathom getting in that much protein. Especially with you having previous liver issues. Too much protein can also shut down the kidneys. I would seek a second opinion for sure.

Haven't had the surgery yet but damn, those numbers seem off. I weight like 35/40 pounds more than you and even my doc and nutritionist have me doing 1000 to 1500 calories a day to LOSE/not gain, while I wait for surgery, and at 90 (protein), 40/60 (healthy fats), 20 (carbs). And even I have issues hitting that when I'm being 100% on plan. The carbs I hit easily due to the veggies but the protein can be hard at times. I'd ask about that again to make sure you didn't hear that wrong or they made a mistake.

Edited April 10, 20215 yr by SummerTimeGirl

Remember, I am at 275 and 7+ years post-op. One thousand to 1,500 calories would be unhealthy for me, and there have been times in the last few years that I have done that and I do not lose. I once fasted for a week and gained a pound. I'm thinking when I go too low on calories, my body goes into fat storing mode.

1 hour ago, GSVguy said:

Remember, I am at 275 and 7+ years post-op. One thousand to 1,500 calories would be unhealthy for me, and there have been times in the last few years that I have done that and I do not lose. I once fasted for a week and gained a pound. I'm thinking when I go too low on calories, my body goes into fat storing mode.

Possibly. I know for me I struggle to get in the 1500 now that I've been on this for over a month. Many times I find myself under 1000 but totally full and satisfied all day and night. Of course the docs and Nutritionist don't want to hear that. They tell me NOT to go that low (as if I do it on purpose) and to stay closer to 1500 if possible. I guess everyone is different.

Edited April 11, 20215 yr by SummerTimeGirl