Meowdy, friends! ? I had VSG on 11/22/23 (the day before Thanksgiving here in the USA ?, almost 5 months ago), and I have not been a very fast loser. While some people may have dropped 20 lbs in each of the first two months post-op, I'm just at almost 40 lbs down since surgery. My Physician's Assistant (we don't meet with the surgeon at all post-op in our program) said I'm definitely a "slow loser" and am about 12 lbs higher than they'd expect me to be right now.

Anyone else out there only losing about 1-2 lbs per week? Anyone who was in this situation and managed to kick things up a notch? And also, anyone who was a slow loser who eventually met their weight loss goal?

I've always been awesome at getting in my water, protein, and vitamins each day. My program pretty much refuses to give us macro goals other than protein, but I know I'm generally under 100g of carbs daily (sometimes much less). Protein, I'm usually at 80g+. Calories, I float around 1000 per day. Water, I get a MINIMUM of 64oz. I took a week off of exercising (elliptical and weights) when I was sick with a cold, and I actually lost the most in that week, so I laid off the exercise for a bit, worried it was slowing me down. I'm going to start back up on it, just because it's a good habit to get back into. When I do the elliptical, it's usually pretty vigorous for 30 minutes, sweating profusely and burning ~400-500 calories. I put on some very loud heavy metal and take out all my frustrations on the machine ?

I'm worried I'm going to be stuck at this weight and that I'm "wasting" this tool and opportunity, or that maybe I chose the wrong surgery. Granted, my current weight is way better than where I was before starting the pre-op diet, and my mobility and endurance are IMMENSELY better, and my IBS-D has basically disappeared (THANK THE LORDT), but it's still not where I'd like to end up. The PA told me that sleeve patients can lose for at least 18 months post-op, so hopefully it's just a slow-but-steady race for me.

I guess I could just use some encouragement or advice or anecdotes from others who were slow but successful, or if someone sees something glaringly "wrong" with what I'm doing.

1-2 pounds per week is actually a healthy rate of weight loss. That's where doctors and nutritionists want to see a person at. But if you want to change things up, try changing your workouts, giving yourself variety in what you eat, weigh and track your food so you know where empty calories and carbs are coming from, Typically, the first 6 months after surgery is the time when we lose the most. After that, weight loss slows way down (you can still lose, but not at the rate that you were). We can definitely still lose weight, but it slows SIGNIFICANTLY and we end up "fighting" to lose more weight. I'm still losing, but it's slooooow going. Slow and stead wins this race.

Also, while every program is different, I tend to think your carbs are a bit too high. Here's what I do:

WORKOUT DAYS:

Calories - 1300-1400 (depending on what I'm doing)

Carbs - 45-60 (again, depending on what I'm doing)

Protein - 90-100g

HEALTHY fats - 50-60g

Fluids - 90+ oz

NON-WORKOUT DAYS:

Calories - 1100 - 1200

Carbs - 20-40

Protein - 60-80g

HEALTHY fats - 30-40g

Fluids - 64oz MINIMUM

Also make sure you switch up your exercises so your body gets "confused"

I agree with @SleeveToBypass2023, a weekly loss of around 1-2lbs is considered a healthy rate of loss & it is where many of us settle at losing after the initial couple of months of higher rates. Then we all seem to slow to a snail’s pace. I’m talking 1-2lbs a month.

This process is so individual. So many factors affect your rate of loss, how much you eventually lose & how long out it takes you. Most totally out of your control.

I wasn’t given macros either. Just the 60g protein & 2 litres of fluid. I didn’t have to track my food either. I did do random checks but that was for my own interest. And I didn’t exercise. I know. The shock! The horror! Lost all my weight & more at a fairly average rate for my height & starting weight to goal. Six months to lose 31kg to goal & almost another year to lose another 11kgs so the 18 months with a sleeve as your PA told you. Your potential for weight loss is not near over yet.

Celebrate & enjoy every pound you lose. Look at those amazing wins you’ve had already. Fantastic!

4 hours ago, SleeveToBypass2023 said:

Also, while every program is different, I tend to think your carbs are a bit too high. Here's what I do:

WORKOUT DAYS:

Calories - 1300-1400 (depending on what I'm doing)

Carbs - 45-60 (again, depending on what I'm doing)

Protein - 90-100g

HEALTHY fats - 50-60g

Fluids - 90+ oz

NON-WORKOUT DAYS:

Calories - 1100 - 1200

Carbs - 20-40

Protein - 60-80g

HEALTHY fats - 30-40g

Fluids - 64oz MINIMUM

Also make sure you switch up your exercises so your body gets "confused"

How do you keep your carbs so low? I am kind of in awe of you right now ?

The bean stew I made for meals is 30g carbs per serving alone (but only 180 calories and 12g protein). I am hitting between 900 and 1,100 calories, 30g fat and +/-70g protein a day.

My guidance was to have +/- 60g protein a day and make good choices for food and eat small portions - no set calories etc.

From reading others posts and feedback on the forum I have already decided to give my regular banana as it is too high in carbs (just two more left to eat!) and I have stopped taking a morning drink of honey, lemon, pepper and cinnamon as the honey made the carbs too high also.

I am a bit freaked out now as my weight loss has slowed down the last three months and I have only lost a couple of pounds.

20 hours ago, FifiLux said:

How do you keep your carbs so low? I am kind of in awe of you right now ?

The bean stew I made for meals is 30g carbs per serving alone (but only 180 calories and 12g protein). I am hitting between 900 and 1,100 calories, 30g fat and +/-70g protein a day.

My guidance was to have +/- 60g protein a day and make good choices for food and eat small portions - no set calories etc.

From reading others posts and feedback on the forum I have already decided to give my regular banana as it is too high in carbs (just two more left to eat!) and I have stopped taking a morning drink of honey, lemon, pepper and cinnamon as the honey made the carbs too high also.

I am a bit freaked out now as my weight loss has slowed down the last three months and I have only lost a couple of pounds.

Don't be in awe of me lol I've had my fair share of ups and downs in this, but I found what works for me personally. Take what you want from my suggestions and toss the rest. But for ME, I noticed that I'm sensitive to carbs. I tend to respond better when I am at lower carbs. I don't eat bread, pasta, potatoes, rice, sugar, little to no salt (and when I do, it's pink Himalayan salt), or fruits high in sugar and carbs (grapes, bananas, and I limit apples). I'm not a fan of chocolate (if I eat it at all, it's in the form of keto brownies and I eat 1 small brownie every 2 days or so). I avoid Starbucks now (didn't used to and noticed my weight would stall a lot more). I avoid cow's milk (almond milk has more calcium and nutrients in it) and if I want ice cream, I get Rebel ice-cream from Walmart (2g or less of carbs for the whole pint of ice-cream, lactose free, 5g of less of sugar for the whole pint of ice-cream depending on the flavor).

There's keto bread and keto bagels that I eat when I REALLY want something that requires those (my avocado toast is something I have 1-2x per week, or I have a keto bagel with sausage, egg, and cheese on it maybe once a week). If I want pizza, I get the ones that have cauliflower crust (omg so good), I have cauliflower rice, and mashed cauliflower if I'm wanting mashed potatoes (cauliflower has almost no flavor so it takes on whatever flavors it's mixed with). If I want sweetener, I use monk fruit sweetener (doesn't raise the blood sugar at all and actually tastes sweeter than sugar). If I want a nice flavored coffee, I buy the coffee shop coffee and make it at home, add almond milk, and put in Jordan's Skinny Syrup (no sugar, no calories, no carbs) in any flavor I'm wanting (they basically have every flavor you can think of). If I want fruit juice, I go to Walmart and buy the sugar free mango splash or sugar free fruit punch. Absolutely DELICIOUS. I drink a lot of flavored water with the sugar free powders, Gatorade zero, and Propel waters.

For me, the trick has always been to eat within the boundaries of my diet while not feeling like I'm depriving myself. Everything tastes delicious and feels like I'm eating like everyone else, but I'm keeping to what I can eat without having to cheat to feel satisfied. I like sugar free tropical popsicles for a treat while my husband and daughter eat the regular stuff. We can all have popsicles together and I don't feel deprived or left out, yet I'm not breaking any of my personal dietary rules.

I also make sure to change up what I do in my work outs. If you do the same things in the same order every time, your body gets used to it and the exercises stop being effective. If you do different exercises in a different order periodically, it will "confuse" your body and everything you do will have a greater impact. For me, not only does exercising help me lose weight, it also makes me feel good physically and mentally. I was 421 pounds and needed a cane to help me get around. Being able to hike 10 miles with my son means more to me than I can even express. So if you're working out, try to confuse your body as much as you can.

I hope some of this helps you out. I never want anyone to think that my way is the only way to do things, but maybe something in here will give you some help with getting out of your slump and back to losing weight at the rate you're most comfortable with

I'm pretty sure the OP is in the same program I was (UW Health in Wisconsin). Their plan isn't low carb, it's balanced. Or it was when I went through it 9-10 years ago.

I cut my carbs to ~20g a day until I hit 7 months, now I am around 40g a day. I pretty much took a modified keto approach to it. 75g of protein a day (minimum), and ~50g fat. I am down 191 pounds in 8 months, but we all lose differently. My daughter took a similar approach but she eats ~50-60g of carbs a day and she has lost 80. My cousin just had it done in Jan, and she has an approach like yours and she is down 30, she is a slower loser.

On 4/17/2024 at 9:44 PM, SleeveToBypass2023 said:

Also, while every program is different, I tend to think your carbs are a bit too high.

When I finally convinced my Dietitian to give me some sort of macros to follow, they actually said "150g per day" for carbs! I thought that sounded WAY too high, and even 100g seems like a lot to me. I've done keto before (and that was the only way I lost any weight at all, prior to VSG), so it's not too difficult for me to cut back there. Thank you for weighing in - I really appreciate it! :)

On 4/19/2024 at 8:50 AM, catwoman7 said:

I'm pretty sure the OP is in the same program I was (UW Health in Wisconsin). Their plan isn't low carb, it's balanced. Or it was when I went through it 9-10 years ago.

Ding, ding, ding - we have a winner! You are correct - I went through UW Health, and their program is still very much focused on balanced meals and not restricting. They give amounts to have at each meal (e.g., 1/2 cup), but I always thought this was a little wonky because a 1/2 cup of beans is way different than a 1/2 cup of sugar. I had to BEG my Dietitian to give me some sort of maximum macros for a day, and some of those ended up being way higher than I'm comfortable with (150g carbs per day), so I'm just kind of going with what makes sense to me...hitting ~80g protein and at least 64oz of fluids, and then loosely monitoring carbs and calories.

I'm going to get back to tracking every day, just so I can be sure it's not what I'm putting in my mouth that's slowing me down!

On 4/19/2024 at 12:43 PM, BigZ said:

I cut my carbs to ~20g a day until I hit 7 months, now I am around 40g a day. I pretty much took a modified Keto approach to it. 75g of Protein a day (minimum), and ~50g fat. I am down 191 pounds in 8 months, but we all lose differently. My daughter took a similar approach but she eats ~50-60g of carbs a day and she has lost 80. My cousin just had it done in Jan, and she has an approach like yours and she is down 30, she is a slower loser.

Yeah, I honestly think that for a lot of us, keto or modified keto (at least in the beginning months or maybe even the first year) is the way to go. I know my program wants us to have a sustainable approach and incorporate all foods, but my body seems to love to hold on to carbs, and I want to get as far as I can in this first year before things REALLY slow down. Thanks for your input!!

hiya! 1-2 lbs loss per week is NOT a slow loser at all.

its actually quite common/average.

you are doing great

17 hours ago, ms.sss said:

hiya! 1-2 lbs loss per week is NOT a slow loser at all.

its actually quite common/average.

you are doing great

Someone's gotta tell my PA this! lol

Thank you for the encouragement - this situation was at least a good motivator for me to re-evaluate what I'm eating (I was getting a little lax with keeping some of the less nutritious things outta my mouth), so if anything, my worries have put me back on track to sustain this lifestyle change longer term.

How are things going now?

On 5/26/2024 at 7:49 PM, SleeveToBypass2023 said:

How are things going now?

Thanks for checking on me!! About the same in terms of weight, unfortunately ?, although I'm bouncing around the high 240s instead of the low 250s now, so there's been a slight change. I'm going to reach out to my team soon if things don't get moving again.

Small update, in case this is beneficial to anyone else going through the same stall & hunger issues in the future!

I met with my Physician's Assistant (we don't see the surgeon post-op in my program - the PA does all the medical legwork) on July 8th since I was stuck in the high 240s for quite a while (roughly 112kg). The PA discussed what I was doing, agreed that I was doing almost everything right, minus somewhat larger portions at meals due to experiencing more hunger. We discussed GLP-1s (Ozempic, Wegovy, Zepbound, etc.), phentermine, topiramate + phentermine, Contrave, and other medication options. Since my insurance would not cover GLP-1s (I do not have diabetes) and they'd all be crazy expensive out-of-pocket, we decided to give the phentermine a try. Note that this is not a good medication to add if you have any history of heart issues - I'm not a doctor, so anything I say is personal anecdote and you should always consult a physician for any changes in your own medications, etc.

Phentermine is a stimulant and an anorectic, which means it reduces appetite and can increase energy. It will NOT cause you to burn more calories without increasing activity, so reducing the amount eaten is critical (and increasing activity helps, too). The PA had me do an EKG in-office that day, and since it came out normal, I was prescribed half of a 37.5mg tablet for the first 4 days, to increase to a whole tablet daily if I still had residual hunger and was tolerating the 1/2 tab well. I did end up going up to the full tablet, as I had no side effects (except for some anxiety the one day I had a cup of coffee in the morning...don't combine stimulants!!).

The result has been that I've dropped 5lbs in the last 2 weeks, and almost a week of that was spent at an outdoor music festival where the food options were far less than stellar (think "carnival foods" - I tried to stick mostly to all-meat options as much as possible, but I did help my spouse with some cheese curds and funnel cake...). I do have Narcolepsy and ADHD, and the addition of a stimulant has been a bit helpful for those conditions, as well. Another plus was that it cost me roughly $7 USD to fill at my pharmacy with insurance, so it was far more affordable for me than the GLP-1s would have been. My hunger has been curbed quite a bit, and this has helped me feel satisfied eating far smaller portions than I was eating previously.

I have a check-in with my PA towards the end of August, and I'm pleased with my progress so far! I had an annual physical with my General Practitioner last week, and my A1C says I'm no longer pre-diabetic ?