Hi all! I am not scheduled for VSG yet, as I am still waiting to get my mental health clearance. That’s the last thing I need before getting the surgical team approval and insurance approval. I met with my dietician recently and she’s encouraging me to start immediately on 1200-1300 calories a day. My surgery could be MONTHS away (who knows because there’s pieces to fall into place before that?) I’m already on 1500-1700 calories a day, which is fine and works ok. However I feel very nervous about going to 1200 calories and being able to function properly at work (my job is semi physically demanding), and being able to maintain a vigorous exercise schedule. I asked the dietitian if I can eat a little more on days when I work out and was emphatically told “no”. With no idea when I’m going to have surgery, it feels risky to my body that I could hurt myself if I’m not eating enough. I understand after surgery that I will have to take time off from exercise. For reference, I am hoping to participate in a four hour swim event on January 1, 2025 and have been training for it. Does anyone have thoughts on my concerns? Is this normal to go this low on calories without surgery even being scheduled yet? I could be waiting for several months.

Wow. Every cell in my body is telling me that this new regime is so wrong. I have no idea why anyone would want you on such a low calorie diet. It seems to me she wants you to diet the weight off rather than have the surgery. Did you ask why ? You are on the lower weight for the surgery. Loose much more and you may be too low to meet the criteria.

My maintenance diet has me on 1500 calories and I don't exercise. If I worked and exercised as I did in my younger days, I would be on about 2200 - 2500 cals a day.

You need to be fit and healthy for your surgery. Such a low calorie diet is too restrictive. Why is the diet not more future proofed, for learning new habits, like less carbonation, less sugar and less carbs. These seem to be the goals that are set by others who have to do a pre op diet rather than a pre op liver shrink diet.

I hope others will wade in and help you here because to me its madness

Thanks summerseeker! I appreciate your thoughts. I’m glad to know I’m not the only one who thinks this seems strange with my circumstances.

This situation is a catch 22 because no one knows exactly what the insurance requirements are and no one will tell us. The dieticians job is to help you lose weight, period. Whether that’s in your best interest or not is where it gets tricky.

On one hand If you are in a supervised weight loss program (the six month requirement by a lot of insurances) they are trying to see if you can lose the weight on your own before they approve it. So in theory if you lose too much they could deem you not a good candidate for surgery. On the other hand, every pound you lose the heathy way should make you that much more fit for the operation (not if you malnourished though). Plus, if you really can lose it without surgery obviously not putting your body through surgery would be ideal.

if the dieticians way is something you have never tried before and when you try it you feel like you can do it, losing weight without surgery is obviously preferred. BUT, just because the insurance company sees progress and decides that you should be able to lose it based on the trend doesn’t mean they are right (they are not doctors and should not be making these decisions IMO). I know myself I have probably lost 1000 pounds in my life but that’s because I have always lost a few and gained them back but never got near a healthy weight. Whether you have tried everything, including the dieticians way, only you know.

I had sleeve three years ago and my high weight was 235 and I’m taller than you. So I was lower BMI as well. On surgery day I was 220ish and I was fine but I did not start losing until my pre op diet began. During my 6 month supervised diet I did follow the diet they set out for me to the best of my ability BUT the cheat days basically offset my progress so I didn’t really lose anything.

Now I am considering revision and there is not any weight requirements as far as I know but I started at like 245 this time anyways so I’m not as afraid to lose a little. I asked him what I should do and he said to keep my Carbs below 40 for now (I am most likely having the SADI so carbs are gonna be most important post surgery). Well I am losing but less than a pound a week so no one is raising any eyebrows at my loss.

Anyways If I was in your position I would reduce my calories by like 100 at a time and see how I felt after a week adjusting to that. (Mayne you can get to 1200 with the dieticians help and maybe you decide that you want to try it once the dieticians way before you decide). On days like you four hour swim I would ask the doctor their opinion because 1200 calories does not seem enough for that level of activity.

I think if it was me, I would stick to eating healthy choices for now. Try out new, healthy recipes and get used to the food you will need to eat post surgery. I would try to get to the 1200 because they are the dietician but portion wise I would cut my calories slowly to get there and see how my body reacted at each stage. (Just be honest with yourself about whether you really need or just want the calories) if I was really losing more than ever before and it seemed like something I could sustain, I would then re-evaluate whether I should be jumping into major surgery just yet. But if I decided that i couldn’t do it on my own and for sure wanted surgery i would talk to my doctor about how much they would like to see me lose to be fit for surgery.

Edited April 13, 20242 yr by ShoppGirl

hmmm...you could always try it, and, if it doesn't work for you say, after 3-4 weeks, then just go back to what DOES work?

or, if it's causing you too much angst, and your current M.O. is not causing you any issues (which sounds like it isn't), why fix what ain't broke?

there is no one-size fits all prescription...find out what works for you and go with that.

good luck! ❤️

I would especially look at how much protein you are getting more than just the calorie count. Perhaps using protein supplements/shakes/powder as part of your intake for all that muscle you are building.

Best wishes

22 hours ago, SecretAgentDD said:

Hi all! I am not scheduled for VSG yet, as I am still waiting to get my mental health clearance. That’s the last thing I need before getting the surgical team approval and insurance approval. I met with my dietician recently and she’s encouraging me to start immediately on 1200-1300 calories a day. My surgery could be MONTHS away (who knows because there’s pieces to fall into place before that?) I’m already on 1500-1700 calories a day, which is fine and works ok. However I feel very nervous about going to 1200 calories and being able to function properly at work (my job is semi physically demanding), and being able to maintain a vigorous exercise schedule. I asked the dietitian if I can eat a little more on days when I work out and was emphatically told “no”. With no idea when I’m going to have surgery, it feels risky to my body that I could hurt myself if I’m not eating enough. I understand after surgery that I will have to take time off from exercise. For reference, I am hoping to participate in a four hour swim event on January 1, 2025 and have been training for it. Does anyone have thoughts on my concerns? Is this normal to go this low on calories without surgery even being scheduled yet? I could be waiting for several months.

Are you male?

I was on a pre surgery diet of 1000-1200 calories max (female) and that's fairly common...Men 1300 - 1500 max.. The amount of exercise I did didn't matter (I was very active). I started May and my surgery was in August..

I was under the impression those calorie limits were fairly normal, am I missing something here? On average not trying to lose weight is 1800 - 2200 (maintenance) based on age, height etc..Sooo dropping to 1200 would still be healthy but allow for healthy weight loss.

Lastly, I understand you're training, but after surgery you will be on even less calories (I'm almost 9 months PO and I get 800 calorie and your swimming event is 2025 - post surgery..so you'd be on calorie restrictions then..what's the difference between now and then?. Training is about building endurance and calories shouldn't matter as long as you're getting what is recommended and the right macros.

Yes, everyone is different but your dietician knows your current weight, goals and objectives. I personally would do as your plan dictates if you want to go ahead with the surgery. Once you go and do your own thing (which I'm assuming is why you need the WLS in the first place) its very difficult to stay on the program. I also realize that your swimming event is important to you, but you need to decide what is most important - the swim event or becoming healthy. Something to think on...

Edited April 14, 20242 yr by BlondePatriotInCDA

Thanks for the replies. Lots to think about here. I appreciate your thoughtful responses.