Surgeon vs Nutritionist

[Lela Clark 41]

I am frustrated and confused. I am six weeks out from my surgery. I had an appointment with my surgeon today. He said my weightloss was going good and everything seemed to be going well. He then proceeded to tell me I am only supposed to be eating 3 spoonfuls of food. And that I would only ever supposed to eat up to six. I shouldn’t be eating anymore soft foods (yoghurt, pudding ect) no carbs and only ever drink Water with no flavors (crystal light). This is so different than what my nutritionist has been telling me. She just said I could work up to half a cup now. She also said I should be able to get up to a cup of food later. Some carbs are good. Yoghurt is good for you. I am so confused. 6 spoonfuls for the rest of my life?? How??

[Arabesque 6,478]

Your surgeon could mean tablespoons. 3 level tablespoons is 1/4 cup. I was advised 1/4 to 1/3 cup to begin slowly increasing as I was able. I could eat barely eat a cup by goal at 6 months. Maybe they were referring to the losing weight phase? I do eat more now: the recommended serving size or a little less depending what I’m eating. I eat more vegetables though: 1-1.5 cups steamed vegetables, 2 cups shredded lettuce.

My soft food stage ended at 6 weeks so you’re plan could be similar. I was still able to eat yoghurt & ‘soft’ foods like eggs, casseroles, Soups etc. but introduced more solid food as I was able. I was low carb but that generally came from rolled oats as a low processed, whole grain & then incidental carbs like in vegetables. I wouldn’t have reached my Protein goals without yoghurt every day (I gave up shakes once at the purée stage).

The no crystal light or other flavours could be because your surgeon wants you off artificial sweeteners as well as sugar. Artificial sweeteners still feed your craving for sugar & many cause irritation & allergies.

I’m just trying to suggest what your surgeon may be thinking but the best answers are going to come from them. Explain you’re confused because what the dietician is telling you is different & you’d like to know their reasons for the recommendations they’ve given so you understand.

[GradyCat 3,692]

That is frustrating when the two are telling you two different things. I'd go with that the surgeon says over what the nutritionist says, but you might need some clarification first.

[Lela Clark 41]

He said no soft foods cause they are easy to eat. he wants me to eat harder foods. He said to listen to him because nutritionist weren’t doctors. He said a shake in the morning and then 3 meals. The nutritionist said 3 meals and 2 Snacks throughout the day because I was getting hungry. My doctor said you won’t starve. He also said are you really hungry. I told him yes, it’s the empty, growing hard hunger. He said get used to it. He actually made me kinda mad. My husband also as he was there. He made me think again why did I do this.

Thank you for your response. I do like the tablespoon idea instead of just the spoon.

[summerseeker 1,848]

Do the best you can in between the two people. You cant please both people. The dietician will be less than pleased to be so put down by such a high and mighty surgeon. I bought myself a bariatric plate to remind myself of portion sizes. I cant even eat the meat portion yet never mind the veg and carbs. So I have 3 meals and 2 Snacks, 1 is yogurt and 1 is home made veg Soup made with milk. Just so I keep my gut moving. Just do your best. Let him sound off and condemn when you jokingly say you ate nothing but take out.

[Lela Clark 41]

Thank you ladies. Summerseeker, I talked with my husband and that is what I’m going to do. He said just keep doing what you have been doing. It’s working. He just freaked me out and brought the regret back and I had been trying so hard to get over it. Again thank you

[Queen ApisM 426]

I'm not sure how your program works, but the people I deal with regularly are the nutritionist and the PAs, more than the surgeon (I am now 6 months out). Unless something goes wrong, I'm not really going to see her anymore or often. If I need advice on stalls, plateaus, whatever, the nutrition team deals with it.

Surgeons are surgeons - they are really great at doing surgery. And while they are a doctor, just because they have a medical degree doesn't mean they are an expert in everything, including the nitty gritty details of nutrition. As long as you are dealing with a credentialed nutritionist (more on this in a min) who is experienced in working with bariatric patients, I would probably listen to them. Now, I did learn from my own nutrition team that not everyone who claims to be a nutritionist is really qualified or licensed (it depends on your state) so just something to be mindful of.

Also, I think we all need to bring some common sense to the table even after surgery. Meaning, we shouldn't leave our common sense at the door just because we are talking to a surgeon/doctor/nutritionist/whatever. If something sounds off, we should ask questions. And, if needed, I wouldn't hesitate to (nicely) say to the nutrition team, "hey, your advice isn't aligning with what Dr. X said. Can we talk through it because now I am concerned." It alerts them to a problem, and they may be able to help "translate" what the doctor may have been trying to say. My guess is that it wouldn't be the first time they hear it.

[Lela Clark 41]

I just spoke with my nutritionist and she said it isn’t the first time she had heard that the surgeon said what he said. Also, the nutritionist I have is affiliated with my doctors office. She asked how I would like to proceed. I told her to continue how we were working on things as it is working. I told her I didn’t want to spend the rest of my life hungry.

[PuraVida37 715]

Update please! @Lela Clark

You are going to find out what works for you. Both of them are right in some ways, and not in others. You'll find your groove. I suggest journaling or at the very least keeping a real food diary so when you stall (and you will, it's just natural) you can go back and reflect on what worked well and what didn't.

My nutritionist says 3 meals and 2 Snacks (a shake included as a snack or meal), 1000-1200 calories, 60-80 gm Protein (doc told me go to 100), and less than 100 carbs. It's working pretty well for me (when I follow it!).