So I eat 4200 calories a day. Long story short.

456 pounds at age 19 had DS

39 now and I weigh 178 pounds

I've been working out 3x a week for two years. Lifting weights.

At first I lost muscle, because I was eating 2200 calories most days maybe 60 grams of protein.

I now I eat 4200 a day and get 250 grams of protein easy but even with gaining muscle I don't gain weight on the scale yet.

I've gained in the past but once I started lifting weights I stopped. I just stay at 178ish.. my doctor wants me to take enzymes but I want to be able to gain weight with food... It's annoying to me I can't even gain a pound.

I'm slowly raising calories 200 at a time. I wait a month then I'll raise it again but does anyone know how many calories I probably need and can anyone tell me for sure how many calories I absorb and how much fat, carbs, protein I absorb? My doctor says he can't tell me because everyone is different but... I need answers. I find myself scared every day I'll lose weight.. it's crazy to me im eating so much but my doctor's kinda not cool.. so I don't trust him last time I took enzymes I ended up getting up to 240 pounds on accident and the idea of gaining that much weight scares me.. I prefer to do it normally I just wonder what the calorie number is need.

What works for you

Honestly if your body is where it’s at with the 178 your really not going to loose anymore weight nor gain really. Not sure if your team explained this to you but a DS is designed to get max weight loss and at a certain point you level out. I went from 325 to 191 with my surgery and it will fluctuate from 191 to 196 depending how I’m eating and what not but I’m 5 years out I believe and I have not gained anything past 196. Have I been scared that I’m going to drop more yes but has it went past 191 not once. Tbh once the body has reached it loss amount it is what it is that is how I have taken it.

Well but I'm lifting weights I'm gaining muscle. I do a seca body scan every four to six months and after losing muscle because of a car accident and a year in a half in bed my doctor told me I'm in danger of heart failure so I started lifting weights. But I'm not gaining muscle instead my fat is going down .. so I do understand my body wants to maintain this weight but there is this thing called cutting and bulking and I'm trying to get into a bulk..

Just based off the fact that I don't absorb half my calories I would think of I eat enough calories eventually I'll gain weight.. it can't be impossible can it?

I was 19 when I had the surgery 20 years ago. I don't really remember what they told me. I don't recall specifically being told I won't be able to gain weight.. but ok. I'll keep this in mind. Maybe I'm just stuck here.

My doctor prescribed my enzymes though he told my my gastric bypass doctor wanted me to gain weight he thinks I should be 190 for my safety ? any more thoughts?

I'm still weak my muscle is normal but on the low end still so I can't stop trying to gain weight imo. For my health.

Well I can tell you I’m 57 it’s been 5 years since my surgery and I can say I have hit my spot where my weight stays where it is, any walking or working out I do just kinda tones my body I have not seen any major muscle gain or anything like that since I have plateaued with my weight. I take it as it is what it is and just maintain.

Makes sense but my doctor told me two years ago that if I lost any more muscle I would be in danger of a heart attack. And I'm 39 and working out has helped me I've gained muscle but I'm just worried I'm not eating enough or slightly under eating because once I'm average once I have a normal muscle ratio I'll be happy to maintain but right now I'm still very close to the danger zone so... ? Well hopefully I'll get more replies because I would like to hear from someone else who's gained muscle..

Like I said I spent a year and a half recovering in bed and lost as lot of muscle. I even have it recorded the drop in muscle so it's very real..

I must make that muscle back I'm just curious if anyone thinks enzymes must help and be the answer maybe I need to gain ten pounds of fat to give by body something to work with... I dunno maybe there's no hope but as at age 50 I can expect to lose muscle I have 9 years to gain like ten pounds of muscle. I must gain muscle...

Again thank you for your response

So how much protein does everyone else eat in order to keep muscle? I expect none of you count calories but you probably pay attention to your protein intake so give me some numbers please... I'm just trying to get to normal. The correct amount to eat every day calories protein carbs.

As of yet I have not seen any doctor who could give me that information... I'm looking for a nutritionist who specializes in gastric bypass. Until then just knowing a protein amount to shoot for would help.

I'm 6"3 39 ,180 pounds

According to the American College of Sports Medicine, "To increase muscle mass in combination with physical activity, it is recommended that a person that lifts weights regularly or is training for a running or cycling event eat a range of 1.2-1.7 grams of protein per kilogram of body weight per day, or 0.5 to 0.8 grams per pound of body weight."

According to the University of Minnesota, "Recommended Carbohydrate Intake: Research suggests that bodybuilders who are trying to gain substantial muscle growth or increased body mass should consume about 5-6 grams of carbohydrates per kilogram of body weight per day."

According to Maxinutrition.com, "Most people require around 20 calories per pound (or 44 kcal / kg) of bodyweight to gain muscle mass. Using a 180-pound (82kg) male as an example, the required daily calorie intake is 3600 calories (20 kcal x 180 lb = 3600 kcal)."

Hope that helps (found in a 5 minute Google search). Good luck!!

That helps but how do I factor in how much I need because of malabsorption.

What's the percentage of carbs, protein and carbs that I absorb or we all absorb from ds? I need to know for the information to work for me.. thanks. Or should I just Google it I sometimes wonder how correct Google is when it says I absorb 60% of protein 40% carbs and 50% of calories.. unless that sounds right to you?

I honestly have no idea. Google it or reach out to a nutritionist. There really isn't anyone on here looking to gain weight, so this might not be the best place to get the information you're looking for.

Oh I found this place and read another thread about gaining weight... That's what brought be me here.. but I'm trying to gain muscle which does weigh something so I guess I'm trying to gain weight but I'm really trying to gain muscle.

Yea I can go out the basic stuff Google tells me but that's what I've done this entire time and like I said I have a appointment for a nutritionist and will see one in just trying to work out stuff with other ds patients but I guess your all happy and healthy so I'll move on.

I think you need to get back into contact with your dietician. Did you say whether you track your food & monitor your macros? Have you still be having regular blood tests as these will show if you are lacking in any nutrients & you can track & monitor any changes when comparing with your food data. This data will help your dietician to help you construct an eating plan that will meet your needs.

There are tests to see if you aren’t absorbing certain nutrients. Like a stool test can identify how much fat is present & if you aren’t absorbing it effectively. I take Creons (pancreatic enzymes) three times a day to help with my protein malabsorption (curtesy of my gall removal - not a common side effect but I was just unlucky). They also help with malabsorption of fats & carbs as well as proteins. Worth a conversation with your doctor if it is discovered you’re have malabsorption issues.

9 hours ago, SleeveToBypass2023 said:

I honestly have no idea. Google it or reach out to a nutritionist. There really isn't anyone on here looking to gain weight, so this might not be the best place to get the information you're looking for.

I kinda agree with this one get with a gastric dr and nutritionists, honestly what your asking most on here are not in that ballpark your in. Once my weight was off was not trying to get it back as of muscle light working out has done fine for me not trying to get ripped or anything, I think having a DS kinda kills that plan or makes it almost impossible.

If you had a DS you are thought to absorb about 20% of the fat you eat, 60% of the protein you eat, and 100% of the carbs you eat. Your doctor should have explained this to you... The intestines can adapt some to the surgery over time, but most studies have shown DS patients continue to have malabsorption. That's the whole point of the surgery!

In rare cases, there is a small number of patients who will lose more weight than they intend, or have excessive muscle wasting. The muscle wasting is normally due to not eating enough protein post surgery. A DS patient needs around 120 grams of protein a day, more if they workout trying to gain muscle.

Are you taking your vitamins? Have you had your labs checked recently?

In the case of someone who has lost more weight than they intended to with a DS, certain enzymes can be given to help them absorb more of the food they eat, or a surgical revision can be done to lengthen their common channel, giving them more length of small intestines to absorb calories from. Of the two, I'd try the enzymes first. If you gained up to 240 with the enzymes, clearly they were effective for you! So why not consider taking them on an alternating schedule, titrating the dose to slowly gain what you need, and then taper off of them and see if you can maintain??

If you want to do this with food you are probably looking at over 4,000 calories a day. That is going to be tough. You can only eat so much food in a day! DS patients usually don't count calories at all, we count macros because it is the macros that help us stay in our target range, since no one really knows exactly how many calories an individual with a DS surgery is going to absorb, we can only ballpark it. But you should be getting a LOT of protein and around 120-150 grams of fat, according to vets who have lived with this surgery for decades. To bulk, most people I know load up on carbs, which is not easy for a DS person unless you want to spend a lot of time in the bathroom, or you are lucky enough to actually tolerate a decent amount of carbs. But carbs will usually put weight on.

If you want more people with DS to talk to, check the bariatricfacts.org forums. We are mostly DS people over there and most of the regular posters are vets. But be prepared, they are fans of straight talk and not everyone likes that!

Edited January 8, 20242 yr by ChunkCat

I don't think you fully understood what you signed up for. I work out 6 to 7 days a week and do not have any bulk muscle. I had the Sadi DS 10 years ago and I can eat a horse without weight gain but also no bulk muscle. Instead, I have excellent muscle definition and can work out at a level not possible before wls. The DS fortunately keeps the weight off, so you will never bulk up. You signed up for this, and it's a fantastic thing for you to be able to work out, eat what you want, and be healthy, especially given you previously weighed over 400 lbs.

Well I signed a contact twenty years ago and I wasn't informed all that much about what I signed up for... Maybe because it was so long ago.. I do now know and understand the deal but the problem is simple..

So I had a car hit me when I was crossing the street and spent six months in a hospital followed by six months of a resting home to recover followed by a heart failure and another five months in the hospital followed by multiple hospital trips and lost all my original muscle..

I was always average strength but it's another thing to be told you might have a heart attack if you don't gain muscle.

So I did everything I was told to bring me to this point. I have gained ten pounds of muscle in the last two years and I gain average of a pound a month.

Only in the sorta person I need advise and someone to tell me what to do so that I don't make mistake. This might be a result of brain damage from my accident or maybe I'm just a big dumb guy I dunno..

But I did my own math if I eat 4200 calories I absorb 2200. So it does make sense I can't bulk however I'm taking enzymes and my doctor said the enzymes turn your ds off so that you can absorb everything you eat with them..

Now I'm fine tuning everything.

Maybe my ds is to powerful and I'll learn that I really can't bulk and yes I look more defined in the mirror I think. But because my skin is stretchy it's hard to tell. I have gone from 175 to 178 so hopefully that's going to keep going up. My only real goal of taking the enzymes is to increase my protein which is 6.1.

Before I worked out I was capable of maintaining my weight but my doctor told me I lost so much muscle that to not regain it would be dangerous to my health

So regardless of anything I have no choice but to gain weight. If that means eventually eating 6000 calories so be it. But I really think the enzymes alone will solve my problems.

I plan to take the enzymes for 3 months then get off then for two months then back on them in a bulk cutting kinda formula however I'll admit I don't know that this will work. I've gained weight in the past getting up to 240 in the resting home but that was eating six full meals a day with no working out and tons of high fat snacks and sense then I've gotten hypoglycemia which makes gaining weight difficult because I can't just devour sugar like I used to be able to. Man I used to love pudding cups...

Anyways no I didn't know what I was getting into I was 19 and all I wanted was to lose weight but to still be able to eat as much as I wanted. Which is what I got. I never understood the risks. Never. That's why I got all these problems and it's hard to dig your self out of a ditch..

I would work out more if I thought it would help but I just lift weights 3x a week and I have a trainer and a bunch of great doctors who help..

The thing is the DS shouldn't kill me.. I should be able to figure out a way to make this work and my real issue is I'm 6"3 and a man so I require 3200 calories a day is what my trainer said. I only absorb 2200 thus I'm taking enzymes I'm focusing on absorbing protein and enough calories to feed my muscle building and I'm getting blood tests and scanning my body for progress it's a really scary time for me because I know I can lose muscle fast if I forget anything.. finding this website has helped me relearn just got crazy this surgery can be... For real you all helped me so much... But I can not except life as a weakling I'm 39 and a man and people need me so I can't just except things the way they are.

If a normal person can build muscle I can to. It may take more work and more intelligence on my part but that fine I'm willing to do anything to be average if that makes sense.. in fact I was debating going to the gym today because my back hurts but you just motivated me to go . ? Thank you. Have a nice day.

Please information is key here any advise on maybe how many calories you eat or your macros would be helpful to me because I do have a little problems working stuff out in my head and so the more information I can't the better I can deal.

I just wanted to say it sounds like you've been through a lot, and I hope the plan you're starting now with the enzymes will have the results you need. It must've sounded like a dream come true as an obese 19 year old to get to eat all you want and not worry about weight gain, but it starts to sound like a nightmare when you're told you must eat thousands and thousands of calories every single day or you could die. That's terrifying. And then again, taking the enzymes could mean gaining more weight than you wanted, and that's not great either. My only advice is to keep a really close eye on things and work with your doctor and nutritionist as much as you can to get the right balance of working out, food choices, and medications/enzymes to get yourself healthy again.