Hello everyone. My name is Tom and I have been a lurker for years. I had my surgery 11-22-22 at 471lbs. I weigh 214, for the moment, as I continue to lose. What a powerful tool this has proven to be! I am so blessed and thankful I couldn't possibly articulate it. With that being said, I feel I could help anyone that needs it just based on my own research for years into nutrition, fasting, and the many diet plans out there. I would be happy to give my own anecdotal experiences as well through losing the 255 lbs so far.

But the point of this post is for me to lean on some of the vets of duodenal switch. I am approaching maintenance phase in around 35-40 more lbs. Does anyone do low carb in maintenance? If so what does that look like? Am I right to assume for us keto is out correct? The fat would be an issue or maybe someone has tried it? My concern when asking about low carb, for me specifically, I have protected my pouch size. I can still barely eat a few ounces of meat or whatever. I could, and may consider, actively stretching it a little when I get to maintenance, but as of right now I am not sure I could sustain on just meat once I am down to maintenance. I have Bilateral knee surgeries coming starting in Jan. I have lost all this weight in the recliner due to health issues. I am lifting, once I hit 300lbs weight, hard 4 days a week. But 0 steps for the most part. That's important because my exercise will skyrocket once I am healed from the surgeries and I will need more calories eventually. Carbs and fat are obviously the most calorie dense so..

Any thoughts or advice would be appreciated!

16 hours ago, TryingtoloseTom said:

I feel I could help anyone that needs it just based on my own research for years into nutrition, fasting, and the many diet plans out there. I would be happy to give my own anecdotal experiences as well through losing the 255 lbs so far.

Firstly...big congratulations on your weight loss success. Amazing results from a recliner. Wowo!!! I didn't have DS and haven't tried Keto post surgery. But I did the diet for a year right before WLS, coupled with intermittent fasting. Despite my efforts I only lost 30 pounds on the average then hit a wall. Eating high fat meats might not be the best for you at this point but everyone is different in how their body responds to food after WLS. Lean meats and veggies is pretty much our food plan now.

I am interested to hear what others have to say on this subject because although I have been able to lose weight adding carbs to my diet (at the urging of my nutritionist and to my keto minded horror), I haven't tried any types of "diets" to get the last few pounds off post surgery. Some say I have probably met my goal weight and the excess pounds are lose skin?? But I don't have a lot of excess to be honest, so not sure about that.

I am also a big advocate of extended water fasting a couple times a year for cleansing purposes, but have not attempted it post. I was told it might mess up my sped up metabolism tool. I don't want to risk that happening. Also, I don't relish the idea of returning to a diet mentality. And I will admit, I enjoy being able to eat some carbs now where before, I could just look at them and gain weight. LOL

Godspeed on your healing process for the bilateral knee surgery. I have a feeling after you are able to get up and move around, you just might lose those last 40 pounds without the Keto, GL

5 minutes ago, BabySpoons said:

Firstly...big congratulations on your weight loss success. Amazing results from a recliner. Wowo!!! I didn't have DS and haven't tried Keto post surgery. But I did the diet for a year right before WLS, coupled with intermittent fasting. Despite my efforts I only lost 30 pounds on the average then hit a wall. Eating high fat meats might not be the best for you at this point but everyone is different in how their body responds to food after WLS. Lean meats and veggies is pretty much our food plan now.

Thank you very much! Congratulations to you as well for your successful journey. It's amazing to finally be free of the fat and, more importantly for me, the addiction to food and the total control/power I have over food now. It's seriously my lifelong dream at 55 so staying motivated was baked in..

9 minutes ago, BabySpoons said:

Godspeed on your healing process for the bilateral knee surgery. I have a feeling after you are able to get up and move around, you just might lose those last 40 pounds without the Keto, GL

Thank you again. I am sure I didn't elaborate or explain my reasons enough but actually I am concerned about slowing down the weight loss. I still eat very small portions and am worried it would be hard to sustain on just protein, without carbs. I like my body running more ketogenic than carbed up with the ups and downs of carbs. Without adding fat, and with our malabsorption aspect of the surgery, I am wondering if its possible or not so much..If I am being honest, at 240lbs, I started eating dirtier with carbs to try and stabilize at 240 until I got my knee surgeries, but then just dropped another 20+ within a month and a half or so. My steps and activity increased, small by normal people standards, but a lot for where I have been, after I got another Cortisone shot to the knees. This just illustrates my concern once I reach goal weight and I am rucking, hiking, and lifting. Those three things will be lifelong for longevity and mobility going forward.

20 minutes ago, BabySpoons said:

I am also a big advocate of extended Water fasting a couple times a year for cleansing purposes, but have not attempted it post. I was told it might mess up my sped up metabolism tool. I don't want to risk that happening. Also, I don't relish the idea of returning to a diet mentality. And I will admit, I enjoy being able to eat some carbs now where before, I could just look at them and gain weight. LOL

Obviously everyone is different as far genetically and such, but I have been extremely low calorie, plenty of short fasts up to three days, and have plateaued at certain points during my weight loss, and after doing a refeed with carbs and basically whatever I want to eat, I recharged my metabolism for another huge run of weight loss. The refeed was usually only a couple days to a few days but less than a week. Now with this approach remember I am lifting weights. I mean hard as I can weight lifting 4 days a week. It sucks! Low energy lifting is not fun but the recomp.. I really believe the built-in calorie burn from lean muscle mass is the most efficient way to permanently stay in shape. Male or female doesn't matter.

IMHO if your metabolism is slow and you are struggling with the last few pounds, I mean the literally like 5-10 pounds from goal BF, man or woman, start lifting weights. The body recomp will floor you. And that weight or really I think just your body composition after significant weight loss without adding lean muscle mass leaves you looking(Sometimes) like a no muscle bag of skin. Flat. It's not fun but the results..

Anyways thank you for the reply and just to make clear if any of the vets care to weigh in, the WLS gave me the tool, the only tool I will ever need again to lose weight. It's so powerful for me that I need to think about slowing down my weight loss combined with, if possible, being low carb and more ketogenic as a lifestyle choice I prefer. I just don't know if low carb is sustainable without the fat calories. that specifically is what I am looking for. Does anyone prefer low carb/ketogenic after surgery and is it possible? I already realize that fats can be problematic, is anyone doing carnivore after DS Sadi. Not my preference but the only option it seems for low carb without the keto fat plan.

Thanks in advance for any tips.

Check out Dr Matthew Weiner Pound of Cure website, you tube channel & podcasts. Practical and informative advice. Five years out & I still listen to his podcasts. A recent podcast he did with his in-house nutritionalist touches on weight loss eating plans as well as maintenance. I believe you can join their nutritional workshops and clinics for a small fee if you’re interested too. I know someone on this forum has and found it helpful (can’t recall who at the moment).

https://poundofcureweightloss.com/bariatric-secrets-what-really-influences-weight-loss-after-surgery/?utm_source=ZohoCampaigns&utm_campaign=What+Really+Influences+Weight+Loss+After+Surgery&utm_medium=email

Thank you and I will!