Starting over post 2 years

[InvisibleEnvelope 2]

Hi all.

First time poster!

Looking to start over, basically. I had weight loss surgery almost two years ago, lost all the weight, and have kept it off. However, it hasn't been for discipline, as my diet is fairly relaxed (too much) and I'm still struggling with dumping syndrome. I don't have a lot of information for the healed/maintenance phase. I've had a couple of requested appointments with my surgeon's office but the nutritionist is...not the best.

So! For those who were given this info or are this far out:

What should my macros be this far out?

Calories per day? Portions?

Any hardcore rules to still follow?

Any tips to get rid of dumping syndrome?

Let's start there. Any info would be appreciated.

Thanks all and hope everyone is doing well on their plans!

[catwoman7 10,846]

seven years out. The only macro I pay attention to at this point is Protein. I have to have around 100 grams a day because we discovered early on that I malabsorb it, but most patients do fine on 60-80 grams.

calories per day is going to vary from person to person. I know women who can eat 2000 and maintain, and I know other women who have to stay around 1200 to maintain. It depends on how tall you are, how active you are, your metabolic rate, and what weight you're trying to maintain. If you're trying to maintain 160 lbs, for example, you can eat a lot more than if you're trying to maintain 120 lbs. That said, I can maintain my current weight if I eat around 1700 calories a day, but again, that's a really individual thing. You just have to play around with calorie ranges until you find the one that works for you.

hardcore rule - weight 30 minutes after eating to drink anything. That one is for life.

dumping syndrome - only about 30% of bypassers have that - I've never had it. But it's caused by eating too much sugar or too much fat at one sitting. You can prevent it by avoiding or limiting the amount of sugar or fat you eat at one sitting.

Edited June 2, 2022 by catwoman7

[InvisibleEnvelope 2]

22 minutes ago, catwoman7 said:

seven years out. The only macro I pay attention to at this point is Protein. I have to have around 100 grams a day because we discovered early on that I malabsorb it, but most patients do fine on 60-80 grams.

calories per day is going to vary from person to person. I know women who can eat 2000 and maintain, and I know other women who have to stay around 1200 to maintain. It depends on how tall you are, how active you are, your metabolic rate, and what weight you're trying to maintain. If you're trying to maintain 160 lbs, for example, you can eat a lot more than if you're trying to maintain 120 lbs. That said, I can maintain my current weight if I eat around 1700 calories a day, but again, that's a really individual thing. You just have to play around with calorie ranges until you find the one that works for you.

hardcore rule - weight 30 minutes after eating to drink anything. That one is for life.

dumping syndrome - only about 30% of bypassers have that - I've never had it. But it's caused by eating too much sugar or too much fat at one sitting. You can prevent it by avoiding or limiting the amount of sugar or fat you eat at one sitting.

Thanks for responding!

I'm at about 125. I've had a lot of weakness, though, and lost a lot of muscle, so I'm wondering if maybe I should up my Protein.

What do you do to get 100g of protein in per day?

[summerseeker 1,833]

51 minutes ago, InvisibleEnvelope said:

Thanks for responding!

I'm at about 125. I've had a lot of weakness, though, and lost a lot of muscle, so I'm wondering if maybe I should up my Protein.

What do you do to get 100g of Protein in per day?

I am 6 months out and only just got the hang of protein. My journey has been rocky. I use a food diary to help me account for everything. I am in the UK so am no help to you but many people will chip in later with US ones. Is My fitness Pal a US one ? There are many that are free and very good. You just need patience to get used to logging foods and drinks. So for example -

A Protein Drink [ if you can stomach them ] about 25gms

Protein yogurt 200mls = 25gms

! boiled egg = 5 or 6gms

Full skimmed milk 18 Fluid ounces = 18 gms

6 ounce chicken breast , baked without oil = 45gms

1 ounce hard cheese about 5 or 6gms

My rules are - always eat protein first, veg second and then Carbs. I rarely get any veg or fruit [ today was 2 grapes, woohoo] I dream of when I can eat Noodles again........ Good luck with your continuing journey

[The Greater Fool 1,937]

Let's get specific about your dumping. I am one of the lucky ones that dump on both sugars and fats, so I may be able to offer some help. We need to get into specifics because not everyone understands exactly what dumping actually is.

How often do you dump? If it's responsible for the majority of your weight loss as you claim then you would be dumping pretty frequently. If it is actually dumping you wouldn't likely be dumping enough to impact weight loss.

What actual foods cause you to dump?

In what quantities?

How soon after you eat do your symptoms appear?

What are the symptoms?

Good luck,

Tek

[catwoman7 10,846]

4 hours ago, InvisibleEnvelope said:

What do you do to get 100g of Protein in per day?

I still drink a Protein Shake every day as my mid-morning snack. That'll pretty much guarantee that I'll get up to 100 grams by the end of the day.

and I agree with Tek - some people don't understand what true dumping is. If you just mean vomiting after eating, that's not dumping.

[InvisibleEnvelope 2]

1 minute ago, catwoman7 said:

I still drink a Protein Shake every day as my mid-morning snack. That'll pretty much guarantee that I'll get up to 100 grams by the end of the day.

and I agree with Tek - some people don't understand what true dumping is. If you just mean vomiting after eating, that's not dumping.

Hi there.

I guess I always assumed it was dumping syndrome, considering what happens, but I could be wrong.

Essentially what happens is I feel really wired after eating, my heart race increases to an uncomfortable level, and I feel super dizzy and faint. I actually have never thrown up from this. It just feels like whatever is in my body is "too much for it".

I've also developed an intolerance for my blood sugar dropping, which is difficult because it's like my blood sugar spikes within 15 minutes, then crashes super fast, and I get similar feelings of agitation, brain fog, feeling light-headed.

[InvisibleEnvelope 2]

Hi there, thanks for responding. Here are answers:

How often do you dump? If it's responsible for the majority of your weight loss as you claim then you would be dumping pretty frequently. If it is actually dumping you wouldn't likely be dumping enough to impact weight loss.

So I never said I was losing weight because of this. I think I lost weight just from keeping on the proper plan initially. I would say I get sick at almost every meal, regardless of the ingredients, but it's severe with anything carb or sugar-related.

What actual foods cause you to dump?

Pretty much everything but it's particularly horrible with carbs, sugar, and greasy/deep-fried foods.

In what quantities?

I don't measure anymore but it doesn't take much. A few bites will do it, or even a small square of something sugary.

How soon after you eat do your symptoms appear?

Within 10-15 minutes.

What are the symptoms?

It feels like my heart is going to pound out of my chest, feel dizzy, head pressure, brain-fog, and overall sense of anxiety. I also get reactive-hypoglycemia...but not true hypoglycemia. My body just responds very poorly to blood sugar drops because they happen so fast, but rarely have I been in hypo numbers.

[The Greater Fool 1,937]

Thanks for indulging my curiosity. To [hopefully] clarify the conversation, black are my original questions, red are your replies, purple my feedback.

Just to ensure everyone is on the same page, Dumping Syndrome is typically related to consuming sugars and/or fats, as has been previously mentioned. Dumping on other foods is exceptionally unusual.

• How often do you dump? If it's responsible for the majority of your weight loss as you claim then you would be dumping pretty frequently. If it is actually dumping you wouldn't likely be dumping enough to impact weight loss. So I never said I was losing weight because of this. I think I lost weight just from keeping on the proper plan initially. I would say I get sick at almost every meal, regardless of the ingredients, but it's severe with anything carb or sugar-related.

Sorry about my misunderstanding. I inadvertently connected two unrelated thoughts. I apologize.

The fact you get sick at almost every meal would tell me you aren't generally dumping. It's not to say that you are never dumping, just that it is not generally what is going on.

• What actual foods cause you to dump? Pretty much everything but it's particularly horrible with carbs, sugar, and greasy/deep-fried foods.

Again, "Pretty much everything" would indicate that much/most(?) of what you are experiencing is not dumping. Dumping is in response to specific foods rather than most foods.

• In what quantities? I don't measure anymore but it doesn't take much. A few bites will do it, or even a small square of something sugary.

I understand that you don't measure, neither do I. "A few bites" does answer the question, though. A 1.5" x 1.5" square of fudge or comparable sugar dense candy can easily make me dump.

• How soon after you eat do your symptoms appear? Within 10-15 minutes.

• What are the symptoms? It feels like my heart is going to pound out of my chest, feel dizzy, head pressure, brain-fog, and overall sense of anxiety. I also get reactive-hypoglycemia...but not true hypoglycemia. My body just responds very poorly to blood sugar drops because they happen so fast, but rarely have I been in hypo numbers.

These comments add I think what are the more important pieces of information.

If this were dumping, you could simply reduce the sugars or fats that might be causing distress. But when it's almost everything, frequently, then it doesn't sound like just or even mostly dumping, if it's dumping at all.

If you are, in fact, over consuming sugars and/or fats over frequently then your initial steps would be clear: stop doing that and see if this fixes your issue(s) in short order. If you've tried yet continue over consuming sugars and/or fats frequently and unable to stop yourself then were I in your shoes I'd get myself to a therapist post haste. [ETA: I have not gotten the impression you are out of control in this way. Quite the contrary.]

This is not a diet or nutrition issue in my opinion. It's not that you're not working to eat the correct foods, it's that eating any foods too often cause physical distress.

Were this me, I would have long ago become a squeaky wheel. I would be camping in my surgeon's or PCP's offices until I got a resolution, or at least significant progress, in fixing whatever is going on. I would not be put off.

Bottom line: Get your medical team to work helping you. Be your own advocate.

Good luck,

Tek

Edited June 3, 2022 by The Greater Fool
speeling

[SleeverSk 617]

to me it sounds like you have issues with your blood sugar levels regulating but I am no Dr I suggest you speak to your Dr and get a referral to an Endocrinologist. I was having issue like this post op and it was my blood sugar levels spiking up and down

[Arabesque 6,449]

On 6/3/2022 at 7:02 AM, InvisibleEnvelope said:

I'm at about 125. I've had a lot of weakness, though, and lost a lot of muscle, so I'm wondering if maybe I should up my Protein.

What do you do to get 100g of Protein in per day?

I think you need to have a blood test to check your protein levels, Vitamins, minerals, sugar, etc. Then you’ll know what your missing in your diet & your surgeon & dietician will be able to best advise you. And as @The Greater Fool said camp out at your surgeon & doctor’s & demand attention until you get answers & a way forward.

I agree completely with @catwoman7’s advice around your caloric needs. We’re not all the same & there are too many factors that influence what you need as an individual. The blood test will help inform what your macros goals need to be - whether you need more, less or are consuming enough.

I really appreciated the 3 monthly blood tests (& appointments) my surgeon & his colleague requested the last three years (just moved to 6months now). We picked up things like how removing my gall reduced my protein absorption, my Vitamin D levels drop a little in winter, I didn’t need to continue to take Multivitamins after I reached maintenance (except D in winter).

I also agree with the advice to cut out any high fat or high sugar foods out of your diet & see if the dumping improves. Hypoglycaemic episodes gives me similar symptoms to what you’re experiencing though. (I usually eat a couple of berries as the little burst of sugar ease it very quickly.) Maybe your reactive hypoglycaemia needs to be explored further with your doctor too.

All the best.

[InvisibleEnvelope 2]

Hi all.

To address this collectively: I have been to *tons* of doctors over the last four years trying to figure this out, as it started even before my weight loss surgery. The short version is that they haven't found anything. At some point, you have to live your life instead of living in a doctor's office.

I get my labs taken every few months: my Vitamin levels are perfect, blood count is great, etc.

I know this is an unpopular opinion in the chronic illness/grey area community, but I truly think the majority of my issues are coming from anxiety. It's created an intense hypersensitivity/vagal response for everything I do, so what I'm trying to do is control the things I can through diet and common sense.

So here I am trying to get macros and lifestyle advice two years later. Time to give it a whirl.