tl;dr at the bottom

I could use some advice. I went to see my dietician today (not a bariatric surgery dietician, I can explain why I am seeing her if you want to know). She knows I am going to have weight loss surgery as long as I hit the goal weight my insurance told me I need to be at. I have to be at the goal weight by June 24, 2023, in order for my insurance to pay for my surgery.

I had a weigh in the doctor's office a couple of days ago and weighed 301, my scale at home said 302. However, on the same day, the scale at a friend's house said 313.

I knew I had this Dietician appointment two days later and I knew she would weigh me. I continued to weigh myself at home (after getting new batteries) and I was at 302 then 299 and today at home I weighed 303, right before my appointment, when I got to her office I was weighed and it said 313.

I am concerned about what to believe since the doctor's office and my scale show similar numbers. I also bought a new scale today and it said 313.

The Dietician told me I needed to eat more protein, which honestly I struggle with. she said I needed 150 grams!! I said are you kidding? that seems like a lot. She used my weight to come up with this number.

Should I really be trying to eat enough protein for a 300-lb person or should I be eating protein for a goal-weight person (mine is 170)?

also, my clothing is loose like I lost the 20 lbs mine and the doctor's scale shows, and not 10 lbs like everyone else's scale shows. Also, I have always naturally been more muscular even when I was 120 lbs and did not eat any protein aside from what is in plants.

tl:dr- should I be eating enough protein to support a 300lb person or should I be eating protein for a "normal" sized person? AND should I trust the Doctors scale more so than the Dietician's scale?

Choose any one scale, if its at home put it in exactly the same space every time. If I move mine to the other side of my bathroom I gain 7lbs.

Is the dietician the one your surgeon uses ? and is this the surgeons advice to you ? 150 grams of protein is not a lot pre surgery. Eating protein will make you feel fuller while keeping calories low. I imagine you need to keep the Carbs low. Can you add what you protein count is usually like, it will help us help you

Are you vegetarian or vegan? There are so many protein options out there now. Find some protein yogurts that you can eat or add extra protein to your milk and yogurt. Dhal is great for protein, add extra yogurt and seeds to top it.

150 grams of protein for a 300 lb person is not too much - and in fact, skewing toward eating more protein vis-a-vis fat and carbs will help you lose weight. Protein takes longer (and more calories) to burn off than do the other two macronutrients, and it can also keep you satisfied longer.

5 hours ago, summerseeker said:

Choose any one scale, if its at home put it in exactly the same space every time. If I move mine to the other side of my bathroom I gain 7lbs.

Is the dietician the one your surgeon uses ? and is this the surgeons advice to you ? 150 grams of Protein is not a lot pre surgery. Eating protein will make you feel fuller while keeping calories low. I imagine you need to keep the Carbs low. Can you add what you protein count is usually like, it will help us help you

Are you vegetarian or vegan? There are so many protein options out there now. Find some protein yogurts that you can eat or add extra protein to your milk and yogurt. Dhal is great for protein, add extra yogurt and seeds to top it.

No, the Dietician is not the one the surgeon uses. I will be having my surgery at a place called the Rockwood Clinic, they have their whole own program with their own dietician. My insurance wants me to complete 12 dietician visits before surgery, and they told me to go to one near me. (Rockwood is 3 hours away). I did ask my insurance about going to the dietician at the clinic and I told them I would rather see a dietician who specializes in bariatric (especially since I have noticed bariatric dieticians take a totally different approach than this lady). My insurance said that it did not matter and that it would be best to see a dietician in my town so that travel would not be so inconvenient. I will be seeing the dietician that the surgeon uses after I get the surgery.

I actually already feel very full the way I am eating now, and the dietician knows this. I did not go in complaining of being hungry, infact, I have eaten when I was not hungry because she wants me to eat every 4 hours 3 times a day and then have 2 snacks, I do not have the snacks, I do not need them. I would be happy eating twice a day to be honest, but the dietician does not advise that.

I do not have any restrictions on carbs, sugar, fats, or anything. I am just not supposed to eat fast food, this dietician wants me to cook everything (I have explained I hate to cook and my current situation does not allow for me to have a normal kitchen).

Currently, I eat tomatoes, sprouts, cucumbers, feta, hummus, avocado, Daves killer bread (thin slice) turkey bacon, ( I usually turn all of that into a sandwich) fage yogurt and strawberries, mushrooms stuffed with cheese spinach, tomato, onions, cilantro. might have chicken in tomato/basil/cilantro sauce or cauliflower pasta with clams. blueberries and apples. I used to drink a protein shake in the morning (mixed with soy milk) but she told me I needed to eat something with it (again I did not complain about hunger) so I added a slice of toast and an apple, and she liked that until a different visit when she said that eating a protein shake for breakfast and having yogurt at lunch was the same as having two giant glasses of milk and I need to stop with the yogurt. Well, I still have the yogurt at lunch and I eat the sandwich at lunch and breakfast and sometimes dinner too. The yogurt has 12-15 grams of protein depending on which one I choose. I also have at least 96 oz of plain water a day. I should add when I eat chicken (which is always either breast or tender never breaded, always cooked in the air fryer) I get so hungry about 20 minutes later it's weird, but chicken has that effect on me and that is why I do not really care for it.

Edited March 23, 20233 yr by New To This23

2 hours ago, catwoman7 said:

150 grams of Protein for a 300 lb person is not too much - and in fact, skewing toward eating more protein vis-a-vis fat and carbs will help you lose weight. Protein takes longer (and more calories) to burn off than do the other two macronutrients, and it can also keep you satisfied longer.

I understand that it is not too much for a 300lb person, but should I really be eating to support a 300lb person? I also am not hungry with the way I have been eating. So I do not know why she started in with the protein thing. I also do not know how I can possibly fit that amount of protein in, especially since I am supposed to be listening to hunger cues and stopping eating right before I am full.

150 grams of protein is only 600 calories. You need to eat the correct amount of protein so the weight you do loose is mostly fat and not muscle. Also protein keeps you satisfied longer so you shouldn't be hungry quickly after eating. My biggest suggestion is not to second guess your dietician, surgeon, etc. Not to be harsh but what you have been doing apparently hasn't worked or you would not need WLS. In order for WLS to be successful, you will have to stop making excuses and follow the plan. WLS is not easy or a quick fix. It is just a tool. You and only you will still have to work hard. Whoever says it is easy hasn't done it! You CAN be successful just like so many others on this site.

What you need to do eating wise before surgery & after surgery is different. Before surgery is to show you can commit to a changed way of eating, introduce you to healthier food options, make you more aware of the nutritional value of what you eat & to lose weight & fat around your liver to make your surgery safer & easier. So a non bariatric dietician should be fine. After surgery, other considerations come into play such as during the staged return to eating solid foods, importance of macros & knowledge of the usually temporary effects of the surgery around food intolerances, nutritional needs, etc.

May be consider seeing the bariatric dietician after your surgery. I know the distance can be prohibitive but you can always have zoom or phone appointments & only travel to see the dietician every month or two. Something to consider.

No scale is the same plus you’re not the same. I tend to weigh myself first thing in the morning before food or drink & usually after pooping. But when I go to my doctor, it’s later in the day, I’m dressed, I’ve eaten & been drinking, etc. Scales on carpet will weigh differently than those on wood or tiles (uneven surfaces). The age of the scales, age if batteries, moisture in a bathroom, dust, etc can affect the accuracy. I didn’t care so much what my doctors scales read as I knew what mine did. They had their records of my weight loss & now maintenance & I have mine. Your weight loss should be the basically the same - if you lose 5 lbs it will show on everyone’s scales regardless what the numbers actually say.

I’m going to presume you don’t have access to a stove & oven which limits your ability to cook your meals. What about a microwave or toaster oven? They don’t take up a lot of room & just need a power point & will give you more meal options.

2 hours ago, Toesinthewater said:

150 grams of Protein is only 600 calories. You need to eat the correct amount of protein so the weight you do loose is mostly fat and not muscle. Also protein keeps you satisfied longer so you shouldn't be hungry quickly after eating. My biggest suggestion is not to second guess your dietician, surgeon, etc. Not to be harsh but what you have been doing apparently hasn't worked or you would not need WLS. In order for WLS to be successful, you will have to stop making excuses and follow the plan. WLS is not easy or a quick fix. It is just a tool. You and only you will still have to work hard. Whoever says it is easy hasn't done it! You CAN be successful just like so many others on this site.

I have completely changed my eating habit, I have already lost 20 lbs since starting with the dietician. I my question is why would I eat a protein amount based on an unhealthy weight? I have made a huge effort to eat the 150 grams today and I feel beyond full and kind of nauseated. I also have not been feeling hungry at all, so I do not know why she would suddenly bring the protein thing up with me.

22 minutes ago, Arabesque said:

What you need to do eating wise before surgery & after surgery is different. Before surgery is to show you can commit to a changed way of eating, introduce you to healthier food options, make you more aware of the nutritional value of what you eat & to lose weight & fat around your liver to make your surgery safer & easier. So a non bariatric dietician should be fine. After surgery, other considerations come into play such as during the staged return to eating solid foods, importance of macros & knowledge of the usually temporary effects of the surgery around food intolerances, nutritional needs, etc.

May be consider seeing the bariatric dietician after your surgery. I know the distance can be prohibitive but you can always have zoom or phone appointments & only travel to see the dietician every month or two. Something to consider.

No scale is the same plus you’re not the same. I tend to weigh myself first thing in the morning before food or drink & usually after pooping. But when I go to my doctor, it’s later in the day, I’m dressed, I’ve eaten & been drinking, etc. scales on carpet will weigh differently than those on wood or tiles (uneven surfaces). The age of the scales, age if batteries, moisture in a bathroom, dust, etc can affect the accuracy. I didn’t care so much what my doctors scales read as I knew what mine did. They had their records of my weight loss & now maintenance & I have mine. Your weight loss should be the basically the same - if you lose 5 lbs it will show on everyone’s scales regardless what the numbers actually say.

I’m going to presume you don’t have access to a stove & oven which limits your ability to cook your meals. What about a microwave or toaster oven? They don’t take up a lot of room & just need a power point & will give you more meal options.

I will be seeing the dietician in the program when I finish my pre-surgery steps 12 dietician visits, 6 weigh-ins, and the goal weight that is set for me, I have to do it by a certain date, which is coming up pretty soon. Then I will start with the clinic that has a surgeon and its own dietician.

As far as meal options I am happy with what I currently eat, I do not like to waste time and energy on making something new every meal. I was just concerned about why she would have me at a normal calorie level but then want to me eat a protein amount that is supportive of a heavier person. Especially since I have not complained about being hungry, because I haven't been hungry. She doesn't even want me to take any vitamins, because she says what I eat I get enough vitamins.

99 grams is what you are supposed to have at 300 lbs in order to lose weight. If you are an athlete then it would be more. So in other words no, you would not eat protein in an amount that supports an unhealthy weight when trying to lose weight, which makes sense because you do not eat anything else at that level (fats, carbs, sugars, calories) to support an unhealthy weight when trying to lose.

protein needs are higher for post-surgical bariatric patients than they are for "normal" people. Most of us eat higher protein/lower carb diets than do normal people. This is percentage-wise, not gram-wise. So yes, the dietitian will likely have you eating fewer calories, but a higher protein to carb ratio. So I don't find her recommended protein level that unusual.

on my pre-op diet, the dietitian had me eating 2200 calories/day. As a 300+ lb person, I lost weight on that, because I'm sure I was eating 3000 or more cal/day to maintain my 300+ lb weight. On the flip side, many 170 lb people (well, women anyway) would gain weight if they averaged 2200 calories a day, unless they're very active. However, in addition to having me average 2200 cal/day, she also increased my protein to carb ratio, to more or less match what it would be after surgery. I lost weight like crazy (over 50 lbs before surgery) - and it was probably a healthy way to do, too.

cutting your intake down to what a 170 lb person would normally eat might not be very sustainable at this point. That would likely be around 1700-cal (for women), give or take depending on your metabolism and how active you are. It was even hard for me to get used to 2200 (although I eventually did) - but I did lose a ton of weight on that.

Edited March 24, 20233 yr by catwoman7

I know you're probably getting tired of this, BUT - first of all, I had a "non-bariatric" dietitian for my pre-op diet as well. But that surgery is so common now they know what they're dealing with and the requirements - or if not, it's easy enough for them to look it up. My dietitian had worked with several pre-op bariatric patients in the past, even though she was a generalist.

also, if you're going to cut calories (which of course you should if you're wanting to lose weight), protein is the LAST macro you want to cut. Protein preserves muscle mass. If you don't get enough, you'll be eating through muscle. As long as your overall calories are lowered, you'll lose weight.

I don't remember how much protein mine had my eating because it was nine years ago this summer that I started with her, but I know I was eating a lot more protein and a lot fewer carbs than I was before I started seeing her.

also, I still eat 100-150 grams of protein a day because if I get less than 100, my prealbumin level tanks. Most bariatric patients eat somewhere in the 60-80 (or some clinics say 60-90) gram range, but some of us need to eat more than that for various reasons.

I would reach out to the surgeon's office and see if you can do video appointments with their dietician. My surgeon's office offered those. I had to go in for the first appointment, but all the rest were over video chat.

You weigh 300 pounds, so yes, you should be eating enough protein for a 300 pound person. This will keep you from losing muscle. But, you'll need to adjust that, as you lose weight. So keep an eye on it.

15 hours ago, catwoman7 said:

I know you're probably getting tired of this, BUT - first of all, I had a "non-bariatric" dietitian for my pre-op diet as well. But that surgery is so common now they know what they're dealing with and the requirements - or if not, it's easy enough for them to look it up. My dietitian had worked with several pre-op bariatric patients in the past, even though she was a generalist.

also, if you're going to cut calories (which of course you should if you're wanting to lose weight), Protein is the LAST macro you want to cut. Protein preserves muscle mass. If you don't get enough, you'll be eating through muscle. As long as your overall calories are lowered, you'll lose weight.

I don't remember how much protein mine had my eating because it was nine years ago this summer that I started with her, but I know I was eating a lot more protein and a lot fewer carbs than I was before I started seeing her.

also, I still eat 100-150 grams of protein a day because if I get less than 100, my prealbumin level tanks. Most bariatric patients eat somewhere in the 60-80 (or some clinics say 60-90) gram range, but some of us need to eat more than that for various reasons.

She actually has me on a 1200-calorie diet, up until the last visit with the protein thing, I have had no restrictions, except to keep my diet at 1200 calories, she told me that she believes that no food should be off limits and that people need to be eating carbs (she was very adamant about that) I was actually scared to try her suggestion of Dave's bread, but I did and I have lost weight. I am also only the 2nd person she had counseled that is on the bariatric surgery track. She does not spend time looking anything up and gave me a whole book on diabetic healthy meals, even though I am not pre-diabetic or diabetic at all.

Edited March 25, 20233 yr by New To This23

Though you may be an unhealthy weight, you still have to fuel your body with protein and vitamins for that size or you will lose muscle mass. Losing muscle mass is enough of an issue post surgery when you are super restricted so you don't want to induce it before the surgery does. Does that make sense?

I have found some dieticians to be very erratic when t comes to what they advise you from meeting to meeting. I have no clue why. I'd ask her for a print out of what macros she advises you to be at and follow the percentages, aiming for over 100 grams of protein. This should keep you at a healthy balance give or take a few grams of protein.

The sad truth is that many obese people are nutritionally deficient because we've restricted ourselves down to 1200 calories or lower which shuts down our metabolism. But we do it because we gain with anything more! Our bodies are rather broken metabolically. Don't stress yourself out. If you are losing at a steady rate and feel good with consistent energy and aren't starving between meals you have probably found a decent balance.

As for the scale I have the same issue from place to place. It is so irritating. In the end go with the scale you will be weighed on for the insurance company (which is probably the surgeon's scale). Then weigh yourself in one consistent spot at home and calibrate your scale to match. This should get you in the right neighborhood...