6 months post op 4 months of stall

[TwinkleToes87 15]

I’m six months postop gastric sleeve and have lost 29.2 lbs post op. I have been stalled or going up and down 6 lbs for the last 4 months. I have been eating 1137 cals 80g Protein a day on average. I work out three days a week cardio and weight lifting. I’m so so sad that I’ve not been losing weight as I have dreams and goals of losing 80 more pounds to be a normal BMI. Has anyone gone through this and made it out on the other side? I asked my practitioner to please help me by prescribing me Zepbound which helped me lose before my surgery. I really need the metabolic support, but she will not until I’m a year post op. I don’t know what to do to achieve my goal. I feel so broken and like my body is working against me.

Age 37

5’3.5”

Highest weight before Mounjaro 293

Starting weight pre op 243

Current weight 212

Perfect blood work just high Cholesterol (genetics)

[SpartanMaker 843]

A few things stood out to me about your post.

1. 1137 calories is oddly specific. Since most people can't be that accurate with their food intake, I'm curious why you used this specific number? Can you elaborate? For example, most food logging software is only accurate within about 10% plus or minus, even if you are really meticulous with weighing everything. Keep in mind as well that if you are eating very many processed foods, Manufacturers are given a pretty wide latitude in terms of the listed calories, so those aren't near as accurate is you might think.
2. Most people drastically underestimate their overall calorie consumption by as much as 20 to 25%, even if they are logging their food. There are a number of reasons, but things like guestimating certain amounts, using "average" calorie amounts for some items, and not counting certain types of foods are common errors. In short, you may actually be eating a lot more than you think.
3. I'm also curious how you came to the conclusion that 1137 calories per day is the proper amount for you to lose weight? It's entirely possible your Basal Metabolic Rate (BMR), is anywhere between say 900 and 1700 calories per day. While BMR is just one component of your overall calorie burn per day, it's typically the largest single component, even if you are super active. If you are only working out 3 days a week, I'd not put you into the super active category. My point is that while it's not super likely, it is possible that you are actually eating at maintenance right now. Especially if you are eating more than you think. (See points one and two.)
4. scales are a REALLY terrible way to track success since they don't account for variations in other tissues besides fat. Water, which is a huge component of your overall weight can fluctuate dramatically day-to-day. Ask yourself honestly, are your clothes fitting differently? There is a pretty good chance here that you have been losing fat, but made up for it by retaining water in your muscles. This is super common in people when they work out, especially when they start a new fitness routine. There's also a small possibility you are actually adding some muscle mass, especially if you are new to strength training. Muscle is much more dense than fat, so if you gain muscle and lose fat, your clothes will fit better, but you might weigh about the same.

My advice is going to sound counter-intuitive, but I'd suggest adding 200-300 calories per day to your diet. Preferably lean Protein. Do this for 4 weeks and then reassess where you're at. If you are really currently eating at maintenance (as you might think from weeks of no loss), then you would be expected to gain a tiny bit in the next 4 weeks. If it's as I suspect and you're actually eating too little right now, eating a little more may actually up your metabolic rate as well as change your hormone balance. This could be just the thing to kickstart some fat loss in the next 4 weeks.

Best of luck whatever you decide.

Edited December 28, 2024 by SpartanMaker
grammatical errors

[Arabesque 7,401]

Great advice from @SpartanMaker as usual. I’d also add if you’re lifting weights you’d be building muscle which is heavier than fat. So you could have been losing some fat during this time while building muscle. May be consider having a dexa scan to measure your current muscle, fat & bone density. Then have another in a couple of months to compare.

Are you still in contact with your dietician? If not maybe arrange an appointment. Because you are aware of your average daily calorie intake, I presume you’re measuring and tracking every thing you’re eating and drinking every day. I’d take this with you to the appointment and ask the dietician to go through it with you in case you are missing something not only in regards to calories but nutrients as well. If you’re a random tracker like I was and am, vigilantly track everything for a week or two before seeing the dietician.

Don’t give up though. The scale may not be moving but I bet you’re fitter, stronger and generally healthier than you were before.

Edited December 29, 2024 by Arabesque

[The Greater Fool 2,043]

Adding to the things that may not be accurate: BMI. BMI is an average that was reduced to a simple algorithm: BMI = weight (kg) / [height (m)]^2. In words: weight * (height * height). This calculation is intended to be a rough estimate to start with not the end all be all it has become.

Such a calculation is closer to "correct" at the middle or average height and weight. Tall people skew to a lower BMI, short people skew to a higher BMI. The taller / shorter we are the more the BMI skews lower / higher.

Body type also can skew higher or lower BMI. Not all of our bodies are built the same yet the BMI assumes they are.

The more muscle we have the more the BMI doesn't work right. Body builders show the extreme of this effect. Arnold at his younger best would weigh in at a very high BMI. But us humans can build enough muscle to screw with our BMI.

BMI is a rough starting place. Once you have the number, it doesn't really matter. How we feel, our health both physical and mental, how our eating and exercise are feeling. These are the real measures.

Whew, done with BMI. But the post goes on.

Then another part of this whole thing is Goal Weight. Simply, It may be wrong.

If we're aiming for a certain BMI or BMI range the BMI discussion above should cause us to think. If it's a weight we were when we were young(er), our body has changed since then. If it's a weight our surgeon or medical team created it is another number intended as an idea that has been turned into a goal to measure us by. If it's based on those on-line calculators they give the average progress and result of someone with our demographics: We as individuals are not average.

Goals are not written in stone. As a target to aim for when you start the process, it's fine. As you progress things change. Our bodies may tell us the original goal is unrealistic. If our body is happy and healthy at a different weight perhaps we should listen.

The thing with goals, we are over the moon when we lose 10, 20, 50 pounds more than goal. Look how unconcerned we are about missing our goals by 10, 20, or 50 pounds. Why is missing goal by 10, 20, 50 pounds the other way so devestating? We misjudged our goals both ways. Ultimately, it's where our bodies that decided where to stop.

If we have goals, we should continually evaluate them and change them as necessary. We have more information about our process now than we did when we started. More now than last week. Be honest. Be realistic.

Good luck,

Tek

[TwinkleToes87 15]

On 12/28/2024 at 11:57, SpartanMaker said:

A few things stood out to me about your post.

1. 
   1137 calories is oddly specific. Since most people can't be that accurate with their food intake, I'm curious why you used this specific number? Can you elaborate? For example, most food logging software is only accurate within about 10% plus or minus, even if you are really meticulous with weighing everything. Keep in mind as well that if you are eating very many processed foods, Manufacturers are given a pretty wide latitude in terms of the listed calories, so those aren't near as accurate is you might think.
   


2. 
   Most people drastically underestimate their overall calorie consumption by as much as 20 to 25%, even if they are logging their food. There are a number of reasons, but things like guestimating certain amounts, using "average" calorie amounts for some items, and not counting certain types of foods are common errors. In short, you may actually be eating a lot more than you think.
   


3. 
   I'm also curious how you came to the conclusion that 1137 calories per day is the proper amount for you to lose weight? It's entirely possible your Basal Metabolic Rate (BMR), is anywhere between say 900 and 1700 calories per day. While BMR is just one component of your overall calorie burn per day, it's typically the largest single component, even if you are super active. If you are only working out 3 days a week, I'd not put you into the super active category. My point is that while it's not super likely, it is possible that you are actually eating at maintenance right now. Especially if you are eating more than you think. (See points one and two.)
   


4. 
   scales are a REALLY terrible way to track success since they don't account for variations in other tissues besides fat. Water, which is a huge component of your overall weight can fluctuate dramatically day-to-day. Ask yourself honestly, are your clothes fitting differently? There is a pretty good chance here that you have been losing fat, but made up for it by retaining Water in your muscles. This is super common in people when they work out, especially when they start a new fitness routine. There's also a small possibility you are actually adding some muscle mass, especially if you are new to strength training. Muscle is much more dense than fat, so if you gain muscle and lose fat, your clothes will fit better, but you might weigh about the same.
   

My advice is going to sound counter-intuitive, but I'd suggest adding 200-300 calories per day to your diet. Preferably lean Protein. Do this for 4 weeks and then reassess where you're at. If you are really currently eating at maintenance (as you might think from weeks of no loss), then you would be expected to gain a tiny bit in the next 4 weeks. If it's as I suspect and you're actually eating too little right now, eating a little more may actually up your metabolic rate as well as change your hormone balance. This could be just the thing to kickstart some fat loss in the next 4 weeks.

Best of luck whatever you decide.

Thank you so much! I actually use Parrot Pal app to track my calories and it gives me an average each week of my calories and protein! That’s the number it generates for me from all my tracking, which I do pretty religiously. I’ll try adding a little more cals it’s just hard because I can’t fit in a lot each day. Thank you again.

[TwinkleToes87 15]

On 12/28/2024 at 22:58, Arabesque said:

Great advice from @SpartanMaker as usual. I’d also add if you’re lifting weights you’d be building muscle which is heavier than fat. So you could have been losing some fat during this time while building muscle. May be consider having a dexa scan to measure your current muscle, fat & bone density. Then have another in a couple of months to compare.

Are you still in contact with your dietician? If not maybe arrange an appointment. Because you are aware of your average daily calorie intake, I presume you’re measuring and tracking every thing you’re eating and drinking every day. I’d take this with you to the appointment and ask the dietician to go through it with you in case you are missing something not only in regards to calories but nutrients as well. If you’re a random tracker like I was and am, vigilantly track everything for a week or two before seeing the dietician.

Don’t give up though. The scale may not be moving but I bet you’re fitter, stronger and generally healthier than you were before.

I agree with you, I definitely feel so much better and in less pain! I just can’t believe for 4 months I’ve been in this stall when it seems that the first year is major weight loss for most people 🥺 I do have regular check ins with my dietician and have been following the advice they give and they also suggested adding some calories but it’s hard to fit in my stomach. But no excuses I gotta do it. Just frustrating and no one on my care team seems to be alarmed or offer any medications even though it’s been 4 months of this. lol

[TwinkleToes87 15]

On 12/29/2024 at 09:52, The Greater Fool said:

Adding to the things that may not be accurate: BMI. BMI is an average that was reduced to a simple algorithm: BMI = weight (kg) / [height (m)]^2. In words: weight * (height * height). This calculation is intended to be a rough estimate to start with not the end all be all it has become.

Such a calculation is closer to "correct" at the middle or average height and weight. Tall people skew to a lower BMI, short people skew to a higher BMI. The taller / shorter we are the more the BMI skews lower / higher.

Body type also can skew higher or lower BMI. Not all of our bodies are built the same yet the BMI assumes they are.

The more muscle we have the more the BMI doesn't work right. Body builders show the extreme of this effect. Arnold at his younger best would weigh in at a very high BMI. But us humans can build enough muscle to screw with our BMI.

BMI is a rough starting place. Once you have the number, it doesn't really matter. How we feel, our health both physical and mental, how our eating and exercise are feeling. These are the real measures.

Whew, done with BMI. But the post goes on.

Then another part of this whole thing is Goal Weight. Simply, It may be wrong.

If we're aiming for a certain BMI or BMI range the BMI discussion above should cause us to think. If it's a weight we were when we were young(er), our body has changed since then. If it's a weight our surgeon or medical team created it is another number intended as an idea that has been turned into a goal to measure us by. If it's based on those on-line calculators they give the average progress and result of someone with our demographics: We as individuals are not average.

Goals are not written in stone. As a target to aim for when you start the process, it's fine. As you progress things change. Our bodies may tell us the original goal is unrealistic. If our body is happy and healthy at a different weight perhaps we should listen.

The thing with goals, we are over the moon when we lose 10, 20, 50 pounds more than goal. Look how unconcerned we are about missing our goals by 10, 20, or 50 pounds. Why is missing goal by 10, 20, 50 pounds the other way so devestating? We misjudged our goals both ways. Ultimately, it's where our bodies that decided where to stop.

If we have goals, we should continually evaluate them and change them as necessary. We have more information about our process now than we did when we started. More now than last week. Be honest. Be realistic.

Good luck,

Tek

lol yes, my body definitely has a mind of its own and wants me to be as big and fluffy as possible 😂 it doesn’t care about my goals. I definitely am open to not reaching my exact goal but my body is still carrying a lot of excess that isn’t healthy. I hope that the exercise and training helps with my composition and just want to be healthy to live longer and move freely! :)

[The Greater Fool 2,043]

22 minutes ago, TwinkleToes87 said:

lol yes, my body definitely has a mind of its own and wants me to be as big and fluffy as possible 😂 it doesn’t care about my goals. I definitely am open to not reaching my exact goal but my body is still carrying a lot of excess that isn’t healthy. I hope that the exercise and training helps with my composition and just want to be healthy to live longer and move freely!

All reasonable goals. Not unlike my goals all those years ago, just simple health and happiness.

Most of what I write is for the wider world of readers. Previous responses covered the the numbers involved in the weight loss phase. I covered the numbers at the beginning and end of the process which are likewise flawed.

Good luck always,

Tek

[ms.sss 15,710]

as everyone has alluded to above, the number on the scale is often not very indicative of your overall progress.

i had a goal weight and goal BMI number. turns out neither were where i wanted nor ended being at. its weird because a certain weight number looks totally different on me at different times. at one point in my life 115 looked "fat" on me. 5 years ago it looked malnourished. then 3 years ago it looked awesome.

these days (i'm 6+ years out), i go by how my clothes fit me (i.e, body measurements). so long as my clothes still hang well on me, i'm all good! when they start getting looser or tighter, then i'll make efforts to correct.

so i guess i'm saying if your clothes start hanging looser on you, that is a better sign of your weight loss vs. the number on the scale.

good luck! 😍

[SpartanMaker 843]

21 hours ago, TwinkleToes87 said:

I’ll try adding a little more cals it’s just hard because I can’t fit in a lot each day. Thank you again.

I hear you on adding more food. It can definitely be hard, especially at this point of your weight loss journey. While I suggested a few hundred per day, you might honestly need to start with less and work your way up. Even 150 calories of lean Protein like chicken or fish would be a good start. That's only around a half cup or so, depending on which food your choose. From there, work your way up to around a cup.