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Maintenance Calories after Surgery?



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Hello! I had the sleeve gastrectomy 9.5 months ago. I've been working on exercising and eating right, but I've been in a bit of a stall these past 5 weeks. I went down from 290 to 170 pounds, but I've been stuck at 170 for 5 weeks. I've been eating 1200-1500 calories a day and still not losing weight. I've done some research, and apparently, your body adjusts to low calories after a while of eating at that rate.

At the beginning of my post-op phase, there were some complications on my end. I didn't eat ANYTHING for two months straight, not even Protein Shakes, and I was only hitting about 20oz of Water daily (which landed me in the ER, but I'm fine now lol). I've looked online, and it says for my height, age, and weight, a good maintenance level would be 2100 calories. I'm eating well under that in a deficit and heavy weight lifting, so I don't know why my body won't drop anything.

I'm worried that my body adjusted to the 0-calorie few months I had, then the 500-1000 calories three months after that. I've only started hitting my 1200-1500 calories in March when I joined the gym. I know the stall is not due to "muscle gain" because I'm not eating in a surplus, and I'm only eating 65-80 grams of Protein in hopes of simply maintaining while I drop fat.

I also read online that apparently people who go through rapid weight loss have even lower calorie maintenance than the average person, and that makes sense, but surely it cannot be under 1200, right? The majority of bodies need 1500 to operate. I'm so confused! When I ask my surgeon about calories, he says not to worry about them and eat healthy, which I'm doing. It's just frustrating because I want to work on building muscle, but I want to lose some more fat before that.

I guess my question is, does anyone know anything about calories after surgery, and/or how many calories are you eating after surgery to help lose weight?

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I did very little exercise and lost on 1200 calories a day. I am maintaining on an average of 1500 a day. I still have a relaxed regime, I walk a few miles a week and work in a very busy charity shop once a week. I am retired so you can see work and exercise didn't help me. I still have a fierce restriction so the calories are ok for me.

I once had a stall of 3 months and then dropped 7 pounds overnight. I began to think that I had finished my journey. Everyone is so different and its heart breaking if you compare yourself to others.

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One of my favorite resources is Dr. Weiner's videos (as well as his book The Pound of Cure and his weekly podcast). He talks about the type of food we eat being more important than the number of calories we eat. Here is one video that I watch probably once a month just to get it into my head. But he has hundreds of videos, so I encourage you to check out all of the playlists on his channel.

Having said that, there's a good chance you're in a stall as opposed to being done. Your BMI is low enough now that you're approaching "normal weight" and weight loss at that point gets really slow and difficult. But it doesn't mean you can't do it!

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I think a maintenance level of 2100 kcal/day for someone 5'7" who's had WLS would only work for someone who was super active - or was blessed with great metabolism. A dietitian I worked with years ago told me people who've lost a lot of weight almost always need about 300 +/- fewer calories to maintain their weight than a person of the same weight and stature who's never been obese. I heard that again from a nutrition professor last summer when I was auditing a university-level course on weight loss and obesity. There's some scientific explanation behind that that I can't remember at the moment, but it's disappointing - but that's the way it is, evidently.

that said, a couple of thoughts. First of all, you may or may not be done yet. After the first year, there were several times my weight loss seemed to stop and I'd think "well, I guess this is it..", and then I'd suddenly drop a couple of lbs. Also, you are very close to a normal BMI. Weight loss at that point is EXCRUCIATINGLY slow. I remember the last 20 lbs being a BEAR for me to lose. But I kept at it and finally got there.

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according to this internet calculator: https://www.calculator.net/bmr-calculator.html **

at your current height and weight, if you did nothing but stand still and breathe, you would burn 1,478 calories a day (i assumed you are are a 30 yr old female to fill in the blanks).

so THEORTICALLY if all you did was merely EXIST, and you ate less than 1,478 calories a day you would be in a deficit and lose weight (how much weight exactly would depend on your activity level, your genetics, your health and metabolism speed).

with that said, i'm with @catwoman7 in that i agree that 2100 cal a day for someone with your current weight and height may be more than maintenance level cals (i.e, you will GAIN weight), unless you are exercising at least 4-5 times a week. see screenshot from the above calculator's results below.

** p.s. as always, pls don't think that this calculator is the be all end all of truth, its just a guide based on AVERAGES. roughly 99% of people with your similar height and weight will fall above or below this number produced by this calculator.

277669185_Screenshot2024-06-10at8_52_22PM.thumb.png.04c23a3312a59de34334276c4e0ed9ec.png

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Posted (edited)

as for whether subsisting on a very low calorie diet for a prolonged period of time affects your BMR (metabolism) in the future, there are arguments for AND against.

one particular study that i found intriguing was the "Biggest Loser Study"..that found that contestants that participated in the study ALL ended up with lower BMR's than before weight loss...EXCEPT for the one contestant who ended up getting WLS. that one person's BMR did not lower like the rest after his wls, in fact, in went back up. obv, the sample size was very small, and the subjects were only observed for 6 years, but still. something to ponder.

you can read the study here if you are interested: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/

or, if you want an easier NYT-read of the same study, here is a link to a more reader-friendly version: https://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html

now for a personal anecdote: i was 300 calories A WEEK for the first two weeks, then 300-400 calories a DAY for a couple months, then 500-600 the next couple months, then 700-800 until i reached goal at at 7 months. i'm 5'2" and at 7 months i was 127 lbs.

fast forward almost 6 years post op and i am consuming 2200+ cals a day and i'm just under 120 lbs. however i also do quite a bit of dedicated exercise (1.5 to 2.5 hours daily), plus other active stuff i just do for fun in daily life. BUT...when i wasn't exercising as much as i am now, i was maintaining at about 1800 calories a day...so at least for me, i don't think my BMR/metabolism was negatively affected after a sustained low cal diet...if anything, i think it got better...though i probably have all the exercise to thank.

Edited by ms.sss

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As the weeks & months pass we slowly but surely increase our intake so I wouldn’t think the low calories we consume is truely sustained as it’s continuously increasing. And it affects our metabolism in the way you’re thinking either. The recognised benefits of weight loss surgery include resetting your body’s set point, digestive hormones & metabolism. Of course the resetting is different for everyone but there is improvement fir everyone & I so love & appreciate how it did that for me.

I spent years & years eating one meal a day or skipping lunch & only eating two meals a day. That is sustained low calorie in my thinking ( years not months) & yes it did wreck my metabolism. I could barely lose anything even following those 500 calorie a day diets (talking a couple of kilograms over 6 or more weeks).

Similarity to @ms.sss, in the first weeks after surgery I was eating around 200 then 300 calories. By 6 months, at my goal I was barely consuming 900. My weight finally stabilised at 18 months when I was consuming around 1300. Now at 5 years post surgery, I eat about 1600 calories yet am still the same weight I was when I stabilised. And unlike @ms.sss, I’m not what anyone would describe as active. Just do a series of exercises using residence bands & stretches at varying times through out the day. I wouldn’t burn 30 calories.

BMR calculators do give you an idea of what your caloric needs might be but as @ms.sss said the results are based on averages much like BMI & the calculators that suggest how much weight you may lose after surgery are. The averages only take into account some basic factors & don’t consuder your individual needs, medical & weight loss history, genetics, activity levels, muscle density, etc., etc.

Actually, have you considered doing a dexa scan just to see where you are in regards to muscle & fat density now & repeating it in the future to see your progress?

Weight loss can continue for 18 months to 2 years after surgery so don’t give up yet and you won’t actually know what your caloric needs are until your weight has stabilises for some time - months or a year.

PS - My surgeon & dietician also didn’t advise to count calories. I just did it randomly out of my own interest & curiosity. Quality of the food I was consuming was more important.

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For me, I live on 1100 - 1200 calories on non work out days and 1300-1400 on workout days. On my weight training day, I tend to go up to 1500 calories. I work out 5 days per week. I also have 2 rest days. My Protein, Fluid intake, carbs, healthy fats, and calories are all higher on workout days, but I still can't get anywhere NEAR 2100 per day. 1500 is really pushing it, but I only do heavy weight training once per week, so it's ok.

For quite a while, my calories on non workout days were 800-900 or so and workout days were 1100-1300, depending on what workouts I was doing that day. As time has gone on, my calorie and food intake has increased, but I still stick to the rule that I eat until I'm not hungry anymore, not until I'm stuffed.

It's normal for our stomachs to hold a little more and our calories to increase as time goes by. What's important is to be selective with where those calories and carbs come from, not to overeat, and to be mindful of moving your body and getting in enough fluids.

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