6 Months Later

[BillyHalleck 12]

Hey all -

So like many of you, I am still trying to figure out what normal means, six months post surgery.

First off, I am so happy I did the VSG - no complaints, I feel great, surgeon was fantastic, their office is responsive and follows up and I am down from an all-time high of 305, 261 on Surgery Day, and 195 Today. Hoping to get to 185.

That's where my difficulty is: In the past 10 weeks, I have lost maybe 5 pounds. I find my weight fluctuates daily +/- 5 pounds, so I only track the lows as benchmarks. (IDK: Water retention, lack of BM, salt...). My low was 194, today 196, the other day 200 (which is a number I hate!). I think I am spoiled by the rapidity of weight loss early on and feeling a little discouraged now that things are slower.

More than that though, my fear is that my portion size is starting to feel almost normal person normal... not my pre VSG by any stretch, but not terribly restricted. I also am getting hungry again... and craving things like sweets again. After a filling dinner at 6, by 9 I think about dessert - and sometimes succumb. Thus far, I havent done anything too terrible, but the idea of making a batch of chocolate chip Cookies has been on my mind for weeks. I feel like I could fall off the wagon at any time. And now that I can eat almost normal amounts again, its not like the little cheats along the way that didnt matter due to space restrictions - I COULD DO DAMAGE!

(BTW- still dont understand the "2nd stomach" when it comes to dessert. If I think about having another piece of grilled chicken, I know I am full, but a bowl of iced cream, suddenly I am starving!)

With slow weight loss, which I understand is normal as I am getting close to goal weight, and growing portions (8-10 oz at a time), cravings for sweets, and inter-meal hunger, I am terrified that I am a few months from seeing an uptick on the scale. Ten pounds from the finish line - which I might hit, but for how long?

So, for my version of the "is this normal" questions:
1. 5 lbs in 10 weeks?
2. 8-10 oz portions 6 months out?
3. How long till 8-10oz becomes, 12, 14...
4. Is this in my control (am I stretching), or is this healing and normal?
5. Why am I hungry - is it psychological bad habits or physical healing and ok?
6. I have no problem getting enough Protein, but are carbs still the enemy, or calories, or fat?
7. Macros, Keto, Calorie counting - academically I understand them all. I cant reconcile the conflicting info. Even my Doc and my nutritionist seems to differ (though they obfuscate to be respectful of one another). Anyone in a similar phase of this process with insight on this part?

And tips:
1. Least harmful Desserts that have worked for you?

Mathing things our has been getting me a little crazy. I have gotten back to espresso/lattes lately, which I find to be a filling snack, but even with skim milk: 100 calories x 2/day x 7 days per week = 1400 calories = almost half a pound a week. Same with the 100 calorie dessert. Thus, if the I'm doing the math right: I am basically eating a neutral calorie amount at this point - evidenced by lack of meaningful weight loss. Avg 1/2 a pound a week for the past 10 = 1750 calorie deficit per week = 250 calorie deficit per day. Does that mean I am a skim milk latte and an apple a way from not losing weight. Then any excess is gain!?!?

I think all I have left in my arsenal is more exercise, which frankly, doesnt seem that probable. If I liked the treadmill, I would be on this forum now would I?

Welcome thoughts & feedback! Thanks all!

[catwoman7 10,862]

the closer you get to a normal BMI, the slower it goes. Those last 20 lbs were a BEAR for me to get off. Took forever. We're talking like 2 lbs a month the last three or four months. But I hung in there and finally made it.

The reason being, your calorie requirements at that weight are MUCH lower than they were when you started. It takes about 1600 calories for me to maintain my current weight. I would have lost weight like CRAZY if I ate 1600 calories when I weighed over 300 lbs. For me to lose 2 lbs a week (which I could have done NO PROBLEM when I weighed 300 + lbs), I would have to eat 7000 fewer calories that week (well, I would have when I weighed 300+ lbs, too). That's 1000 fewer calories a day. When I was scarfing up 3500 kcal/day, that means I would have had to cut back to 2500 kcal/day. Now I would have to cut back to 600 per day. Ah...no. I could do that the first couple months out of surgery, but 600 calories a day at seven years out? No way. Plus it wouldn't have even been healthy. So I basically lose a couple lbs a month when I'm trying to lose weight.

8-10 oz portions - would depend on what it is. Greek yogurt, yes. Steak - no.

Stretching your stomach - probably not. You'd have to really overeat, day after day, every day, to do that.

you are hungry because physical hunger does come back for the vast majority of us sometime during the first year. And that's when things get a lot harder.

I've never counted fats. And I wasn't on an ultra-low carb plan (mine was balanced), but the first few months, I rarely ate over 80 carbs a day since I had to get in so much Protein. There wasn't room for more than about 80 carbs. Now i probably get double that - but I limit the "bad" ones. Mine mostly come from whole grains, fruits, and vegetables.

exercise isn't that effective in helping you lose a bunch of weight unless you're talking swimming mega laps or running marathons. But it's great for your overall health, and you should do it regularly if you can. It CAN help you maintain once you get to goal, though.

Edited February 17, 2022 by catwoman7

[BillyHalleck 12]

Thanks Cat! I guess its just a matter of watching even the small things. Not used to thinking about food in that way. From not caring at all, to not being able to eat. I guess this is the first phase where I have to actually think carefully about food choices and be cognizant of every calorie choice. Appreciate the feedback and support!

I think I am realizing that the training wheels fell off and now I am panicking a bit. Time to buck up?!?!

Edited February 17, 2022 by BillyHalleck

[catwoman7 10,862]

4 minutes ago, BillyHalleck said:

Thanks Cat! I guess its just a matter of watching even the small things. Not used to thinking about food in that way. From not caring at all, to not being able to eat. I guess this is the first phase where I have to actually think carefully about food choices and be cognizant of every calorie choice. Appreciate the feedback and support!

I think I am realizing that the training wheels fell off and now I am panicking a bit. Time to buck up?!?!

I just added some more stuff to my message - (I accidentally saved it before I was done saying what I wanted to say!!) - so go back and check out the updates.

[BillyHalleck 12]

Thanks Cat - appreciate the extra detail. I have been perplexed by the carb piece. That is really good guidance!

Patience and persistence... no way around it!

[Arabesque 6,475]

Yeah, sadly, those heady days of a high rate of weight loss don’t last. You can always depend on your weight loss slowing the closer you are to goal. You’re eating more (which is a normal progression) & getting closer to the number of calories your body needs to maintain your weight.

As @catwoman7 said how much food you eat depends on the food you’re eating. A good place to begin is to look at the recommended portion sizes of different foods - start with google & quiz your dietician on what is a serve of beef, of chicken of vegetables, etc. You’re probably getting to close to a recommended serving size now. The problems only start to arise if you’re eating more than that & the only thing that will stop you eating larger portions sizes is you. Plus check the calories of what you’re eating & the nutritional content if you’re not still doing this. 1500 calories is 1500 calories regardless of whether it’s from nutritionally dense food or from cake, sodas, chips, pizza, etc. I eat more often & eat more food in a day now than I did when I was obese. It’s just more nutritionally dense food & my my metabolism is working better.

As to what’s bad: carbs, fats or sugar? I think this is a personal thing. You know your medical status which would influence whether you should keep your fat intake low or not. You know your weaknesses - sugar, carbs. I think we should work out a lot of our eating plans based on these things about ourselves. There are recommended daily allowances for fats, sugar & carbs too. Generally, I’m a bit of a balanced diet person. Though I don’t eat a lot of carbs & only multi or whole grains - I used to eat a lot of bread, Pasta & rice. I also avoid a lot of sugar, artificial sweeteners & sugar substitutes because I think sugar is the real devil. I get my sweet from fruit.

I don’t have dessert as such but have eaten chia pudding (flavoured with vanilla extract). I’ll have a Protein Bar after dinner if my Protein is a little low for the day or will have fruit.

How I feel real hunger is very different. I feel restless & I don’t crave a specific food or type (salt, sweet, carb) of food. If my ‘hunger’ is craving something specific it’s head hunger & not real. If there’s an emotional component to the ‘hunger’ (like hangry) it’s not real hunger.

Part of the ‘fun’ of maintenance is working out your calorie & nutritional needs. It took me a while to work out what mine was & to be physically able to eat that much food. But you have to find a balance too. If you have to have such a restricted diet to maintain that it compromises you enjoying your life, it’s doomed to fail. It’s about sustainability. If that means you end of weighing a little more than you thought you wanted to be, that’s ok. If you enjoy your latte every day enjoy it. If it worries you try a smaller serve or reduce it to one a day or three cups every two days. There’s always work arounds or substitutes you can make like zucchini noodles instead of spaghetti but still enjoy what you’re eating & not feel like you’re missing out.

The truth about exercising is that it will only contribute to 10-20% of any weight you want to lose. Want to lose 10lbs? Exercising will only contribute to you losing 1 or 2 lbs. Plus if you increase your exercising, your hunger will increase.

Unfortunately the work doesn’t the end. All the best.

[LaoDaBeirut 158]

If you have a chocolate chip cookie craving, Quest makes a Protein cookie that isn't bad although they're really expensive.

[njlimmer 338]

I am feeling this post so hard. SO HARD!!!!

[BigSue 1,320]

Lots of good questions, some of which I’m still trying to figure out. I’m concerned about the volume of food I’m able to eat 1.5 years out, BUT I have made major changes to what I eat, so my calorie consumption is still quite low.

I have some go-to desserts:

Protein Bars - there are some incredibly delicious ones out there that taste like candy bars. You do need to be careful because some of them are loaded with sugar and high in calories. My favorite is Built Bars, which taste amazing and are lower in sugar and calories than most brands.

Meringue - egg whites are MAGICAL. I use the same basic recipe three ways. For 25 calories, I take 1 serving of pasteurized egg whites (from a carton), 1/8 tsp cream of tartar, pinch of salt, 1 tsp flavoring of choice (I like half butter flavor + half vanilla, and there are tons of options if you look at LorAnn or One On One flavors), 1/2 cup Splenda, and whip in a stand mixer to stiff peaks.

I eat it fresh over sugar free Jello (it’s very similar to whipped cream). Or I freeze it and it tastes like ice cream (makes about 1 cup, for just 25 calories!). Or I pipe it in little circles and bake to make meringue Cookies (I usually get about 20 cookies in a 25-calorie batch), sometimes using light yogurt as a dip/icing.

Plain rice cake (35 calories) sprayed with I Can’t Believe It’s Not Butter spray and sprinkled with brown Swerve and cinnamon.

[rjan 163]

On the weight loss slowing, everyone here has already said that's totally normal. But since I'm a total nerd and tracked my weight loss, I can tell you exactly how mine slowed down. I've lost a total of 70 lbs over 23 months.

• Month 1: 3.5 lbs a week, reached -22 lbs
• Months 2-4: ~1.5-2 lbs a week, reached -41 lbs
• Months 5-12: 0.5-1 lbs a week, reached -63 lbs and passed my original goal weight at 11 months out
• Months 13-20: 0.2 lbs a week, currently at -70 lbs, 12 under my original goal

Quote

Not used to thinking about food in that way. From not caring at all, to not being able to eat. I guess this is the first phase where I have to actually think carefully about food choices and be cognizant of every calorie choice.

Does this mean that you pretty much never dieted before you got surgery? Or are you comparing now to the first 6 months after surgery, where you didn't care about food much simply because you weren't hungry?

After reading these boards for a few years, it seems that the people who have long term success do have to pay some attention to their diet to maintain their weight loss. But that takes a lot of different forms according to the specific issues and goals of different people.

You won't necessarily have to pay as much attention to it in the long term as you do right now. Right now you're learning what works for you; later it will become habit. Especially if what you said above means that you never dieted much before - in this case you would be learning about what works for you for the first time. But for everyone, after bariatric surgery, you have to learn what your "new normal" is.

Personally, my long term goal has been to maintain without having to calorie count. Before surgery, I was pre-diabetic and low carb was the only thing that ever helped me lose weight. After surgery, carbs are still an issue for me, though much, much less of an issue than before. Rather than limiting/counting carbs every day, I've found that having a 4-5 day period of low-carb every 3-4 weeks keeps my carb cravings in check. I still start my day with a Protein Powder latte and make sure that I have Protein with every meal. Veggies help keep me full. If I feel hungry, I eat a snack, but I usually start with a piece of cheese or a few frozen meatballs (I love these things) before I have anything more junky. I eat sweets some days, but not all. I use things like sugar free ice cream or low sugar yogurt for a bit of a treat on other days.

Edited February 17, 2022 by rjan
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[BillyHalleck 12]

@Arabesque Thanks for the thoughtful response. The experimenting is part of the fun. And this forum is great for guidance. Understanding normal after 30+ years of bad habits, bad family habits, and frankly, an American culture of obesity and gigantic portions has been a challenge. While I have not even had the desire to follow any of my 300lbs habits, trying to gauge what is appropriate both currently and as a trajectory has been unclear - and I guess its supposed to be. Thanks again!

@njlimmer Glad to not be alone in the confusion!

@LaoDaBeirut Ordered - appreciate the tip!

@BigSue Thanks for the meringue tip. Definitely going to try. Nervous about Protein bars - I really like the thinkthin lemon bars, but at 230 calories (though well balanced, making that a habit would be 1/2 lbs per week - basically my entire weight loss. Love a 25 calorie option! Great tip!

[BillyHalleck 12]

@rjan Many diets over the years, with mixed results. Had a long "f*** it" phase, which is what I meant by not thinking about it at all. Then post surgery for the first few months, there wasn't really much I could do wrong given my 4 bite max at every meal. Now I can eat a real meal, and get hungry again, so being cautious is somewhat new. Prior to surgery, my best weight in the past 15 years was around 240, so even what was being careful then isnt too helpful in the 190s and hoping to still drop a little more.

Love the tracking - very similar progression as I am on. I am optimistic that at month 20+ i am still slowly dropping and not heading in the other direction. I think part of my concern stemmed from talking to a guy at work who I hadnt seen since pre covid, and sadly, he looks close to where he was pre surgery. 1 year of losing followed by 2 years of gaining, now back in roughly the same spot. He's not an idiot, but bad habits die hard. Dont want to end up there.

I also dont want to calorie count. I want the occasional dessert at a nice restaurant or a friends party. Keeping the balance and not letting one dessert, or a vacation turn into a trend is the fear. If I get in the habit of a 9 pm snack, multiplied out, does that still allow me to lose weight. Does it "open the door" to an apple becoming an apple with Peanut Butter, to a reese's peanut butter cup... I know, up to me, but the slippery slope effect is real.

Now snacking on meatballs is a new idea. Sounds very satiating. Might try that midday.

Thanks for the thoughts and tips!

[Jue 73]

Go on the recipes on Pintrest theres loads of diffrent meal , Breakfast and snack ideas and also protien drinks it's got some really good stuff on just type biatric surgery recipes

[NolaJay 6]

I’m sorry you’re having a few concerns but this post is so comforting to me. I’m 8 months post op and I can notice that I’m able to eat more, that full feeling doesn’t come nearly as often (if at all) and I’m slipping back into old habits with snacking. It’s been helpful to read your post and some of the responses!

[vikingbeast 985]

I also am six months (almost) out and have some of the same feelings. Slider foods—ones that you can eat a lot of without feeling the restriction—are real. So what I do is I tell myself if I still want it in two hours, I can have a little bit. Then I put a portion in a bowl or on a plate and only eat that. No taking the entire container or package out of the kitchen!

Carbs are NOT the enemy. Your body needs carbs for energy, and the more active you are, the more carbs you need.

Fat is NOT the enemy. Your body needs fats for hormone balance, especially for people who are AFAB.

I finally went to a nutrition program where I have a coach who helps me once a week. I plan my meals and sometimes things happen and I go off the rails—but just for a meal or maybe a day. Then it's right back on the horse.

I am still losing about 1 pound a week, and I'm around 15-25 pounds from my ultimate goal (how much exactly will depend on the results of next Wednesday's DEXA scan, since my goal is sub-20 body fat percentage, not a scale number). It might take me six months or more to lose it, and that's okay. The longer it takes, the more eating the 'right' way feels normal.

For reference, I'm only a little taller than you but significantly heavier. I am extremely active (workouts, running, coaching, working outdoors) and I am losing a pound a week on about 1700-1800 cals a day, split pretty evenly among Protein, fat, and carbs—about 140P, 160C, and 60F. Every body is different.

Just rein in those habits now.