Arabesque

Congratulations on your weight loss & maintenance. To lose more, go back to the basics of what you were eating & doing when you first stabilised. Your old protein & fluids goals, watch portion size, keep your carbs, fats & sugars low & track your food. You’ll then need to reduce your calorie intake to lose weight. (Remember, exercise only accounts for about 10% of your weight loss so upping your activity to help your weight loss will only help with the loss of about 2 lbs in your case.) Given that you’ve been stable all this time, the weight you’re at may be your body’s set point - the weight it is happiest at & functions best at. It’s easer to maintain this weight & much harder to lose more & then maintain a lower weight simply because your body doesn’t want to be at a lower weight. To maintain weight lower than your set point will require you to always work at it & to eat fewer calories than you do now to maintain. Will this be sustainable & manageable? Will a lower weight & reduced calorie intake limit or restrict your lifestyle? Just something to consider.

I wouldn’t think it’s all that normal at 3 months out. Sure the odd bout of nausea or feeling a bit off, or some foamies if you eat something too dry, coarse or eat too quickly but full & regular vomiting …no. I’d go back and ask for some testing to be done to work out what’s going on. Being on such a narrow diet & vomiting could mean you’re not getting in all the nutrients & fluids you need. Has your surgeon at least given you some anti nausea meds or something to stop the vomiting?

It could be from eating too quickly but it could also be that some foods just seem to sit more heavily too (potatoes, bread, rice & pasta still do for me) & make you feel uncomfortable. Check your portion sizes too. Not necessarily that you may be eating too much but more that it’s too much for your healing tummy to manage at the moment - we all heal differently & can mange/tolerate different foods & portions. Try smaller portions & try some different purée options. Sometimes we just have to be more tentative in our choices &/or go a little more slowly through the stages.

Okay, I’m going to go down the straight talking path first so be warned. Cheating is cheating. A slip is different. A slip happens once & then you work to ensure you don’t repeat it. It’s understandable & relatable - everyone slips along the way in some way or other. Cheating implies you are doing it repeatedly. Only you know which category you fall into. This is just the beginning. After surgery you have at least 6 more weeks of restricted eating then months of following a eating plan to support your weight loss & your adopting better eating habits. Not everyone loses their appetite & has no interest in eating in the months after surgery. Our battles with eating do continue in some form or frequency even for those who lose their hunger in the beginning. The surgery isn’t a magic cure. It’s just a tool which works best if you put in the work. It isn’t easy but so worth it. When you reach for that chicken, etc., remind yourself why you’re doing this. Also reflect on why you’re reaching for it: a craving, an emotional need so for comfort, are you bored, angry, sad, annoyed, stressed, is it a habit, etc.? Try looking for a distraction. Go for a walk, read, ring a friend, craft, play a game, garden, check social media, etc. Try having a hot drink instead too. These can be useful habits to adopt long term. Now the softer path: Some plans do allow one meal of lean protein & vegetables & two protein shake meals on the pre surgical diet. (Some surgeons have a preferred plan they put all their patients on while others put different patients on different plans based on individual needs & circumstances.) Speak with your team to see if they would be willing for you to follow a modified plan instead of the all shake diet. It doesn’t hurt to ask & they may say yes. You can do this. All the best.

Some people do struggle with eggs. Not sure why just our sensitive tummies I think. They can be quite rich. They also may not have been runny enough for the purée stage. Sometimes we’re (our tummy) just not ready for certain foods even though our plan says they’re okay to eat. Leave them a week or so & then try again. It may take a few attempts for your tummy to be able to tolerate them. You may have similar experiences with their foods too.

Is it the incision on the right side? This is the one where they usually pull your tummy out so it may be additionally bruised & strained if it’s that one. (It’s often a little larger too.) But yes, if it is warmer to touch, inflamed, etc. you may have an infection & will need antibiotics.

I cooked with mushrooms from soft - omelettes usually but also mince dishes & casseroles. I would think it would be a no to wings for some time. One of our biggest enemies is food that is too dry & coarse especially in the first months. It can sort of get stuck & cause the foamies. Chicken breast, even skinless, is a common culprit. So a wing which is traditionally drier would be worse & then frying it, even air frying would make it more dry & the crispy skin would be dry & coarse as well. Even in soft food, you food should be moist, tender & have some sort of gravies, sauces to help you chew & swallow the food. If you want chicken, try thigh (boned or deboned), baked or sautéed in a pan & flavour with any herbs or spices you usually enjoy with your wings. Thighs are more tender (& flavoursome). Of course check with your team. Plans can be different as we all know & then it depends upon what we can tolerate.

Oh yeah the constipation. I swear I never thought about, read about, wrote about, talked about constipation as much as I did for the first years after surgery. You can add some Benefibre to your shake to help with the constipation. Ensure you’re getting in your fluids or are close to your goal. And as @catwoman7 suggested a stool softener or other laxative medication. Start with a gentle one & see how you go. But it’s too be expected that you don’t need to go every day in the first months. You’re not eating a lot & therefore don’t have that much to poop out. Your weight loss is never consistent @Siberian1. If you graph it you’ll notice it goes up & down, zigs & zags, & sometimes is a straight line. This is just how it goes. A lot of factors influence your weight from fluid retention, pooping or not pooping, hormones, drinking a little more or a little less, etc. As long as your general trend is downwards you’re doing okay. If the numbers on the scale are messing with you step away from the scales. Weigh yourself once a week or fortnight or even monthly.

Had a thought. You could possibly have an egg flip. Blend egg, milk vanilla & a little nutmeg or cinnamon. But check with your team.

Unfortunately no. Eggs are a solid food. Liquids mean you have to be able to drink the ‘food’ - no chewing.

I echo the advice to go back to your surgeon for guidance & if you haven’t got one, find a dietician/nutritionalist with experience supporting wls patients. There are differences in plans, your very quick cycle through the return to eating stages as an example. But we ourselves are very different & consequently have different needs. For example I’m shorter, probably older, likely had a different weight loss/gain history, had no comorbidities before surgery & aren’t very active. I wasn’t given calorie goals only portion size: 1/4 - 1/3 cup from purée slowly increasing to about a cup at goal which was 6 months. I remember for months it would take me three days to eat two scrambled eggs. I could eat one egg at 6 months - just the egg nothing else I didn’t have to track calories but I know I was barely consuming 300 in around the soft food stage & was barely eating 900 calories at 6 months. My plan did not allow for any rice, pasta or bread at any stage while losing. Beat advice is to go slowly & be more tentative with your food choices while you are healing (& it does take a few weeks). The staged return to eating we work through is to protect & not strain your healing tummy & support your recovery. Remember all those staples & sutures holding your tummy & digestive system together & all the nerves that have been cut too. All the best with your recovery & weight loss.

Yeah, chicken especially breast can be too dry & cause problems for many. Chicken thigh is more tender (& tastier too) & can be easier to tolerate if you really want chicken. Salmon can to be too rich & oily but try poaching it in milk or stock with some fresh herbs. Otherwise any flaky white fish is good. I can’t recall my first real meal but I think I made a chicken casserole. It had white wine in it which was a bad decision to include - it was all I could taste & was awful. I also ate a lot of beef mince dishes in the soft food stage (rissoles, bolognese sauce with zucchini noodles, etc.). Generally I was able to eat most meats without issue from when I could have the. including steak which causes problems for some. Just make sure you have a sauce or gravy with your meat to help it go down more easily & keep it tender.

It can be difficult to hit those goals in the first few weeks but as long as you are making an effort & slowly getting closer you’ll be fine. You’re only a couple of days out so relax. I could only consume one shake & a soup a day during the post surgical liquid stage but slowly after that I found I could eat a little more & more. Try not seeing your shake only as a meal but as a liquid you just keep sipping. I used to dilute mine (sometimes doubled the water) because it tasted so awful & then sipped it for a couple of hours. You may be able to get more in that way.

Are you on a PPI (like esomeprazole)? Stomach acid can make you think you’re hungry with hunger pangs. Stomach acid is often greater at night because of the fasting period when there isn’t any food in your tummy so the acid isn’t being used to breakdown it down. Also a growling tummy in most instances don’t indicate you are hungry (like we were always told) - it’s just our digestive system working. The hunger could actually still be head hunger. Our heads are a very powerful organ & can really mess with us. Your hunger could be caused by your emotions. The surgery & change of diet is stressful & the hormonal flush can make you emotional. For many of us we used to turn to food in stressful/emotional situations to sooth & comfort us. At the moment you can’t do that but your head is still telling you to eat. Also you can be simply wanting/craving what you can’t have. Subconsciously, you can also be questioning how such a little serving of food can actually be enough to satisfy you. All your head messing with you. I discovered my real hunger feels very different than the ‘hunger’ I used to know. I get restless, think something is wrong but aren’t sure what at first. There is always a reason I am hungry (missed a meal, delayed eating, didn’t eat enough for the day, etc.). I never crave or want to eat a specific food, flavour or texture… except I find I only want something high in protein. Distraction can be helpful. Read, go for a walk, undertake a hobby like gardening, drawing or crafting, play some games board or online, ring a friend or family member, clean out a drawer or cupboard, check social media, etc. Sometimes a warm drink can help.

I’m sorry you’ve developed theses complications. It’s so unpredictable how our bodies work & react to the changes to our digestive system post surgery. I was fine after my sleeve but jump to 25 months later & my gall was removed & suddenly I had a protein absorption issue. I also stopped absorbing my HRT meds. Malabsorption after gall surgery can occur but I was told it’s quite rare for it to be with protein. I wonder if some of the treatments women use for osteoporosis would help? Not HRT of course but prolia & evenity. 🤷🏻‍♀️ Worth asking your doctor. There must be research & treatment plans about because osteoporosis in men is increasing. PS - I use a mouth spray for my D3 K2 (I take it winter when my levels drop) though it is only a low dose (1000UI) but someone might produce a higher dose to boost your intake. The spray means your digestive system is bypassed & it is absorbed directly. Sorry just read you can’t take vitamin K.

Ask your team to recommend a dietician/nutritionalist @PennyinAL especially one with some experience with supporting wls patients. My surgeon recommended mine. And don’t be afraid to ask for as much guidance & information as you think you need to keep you on track. Also be very honest with them. They can’t offer you the best advice & information if they only know part of the story. I was only given protein & water goals & portion size recommendations from my surgeon, wasn’t even advised to track my food but I was ok with that (though I did randomly check my calories for my own information). I’m someone who does a lot of their own research so I think my dietician was confident in what I was doing & also by the questions I asked her. Dieticians/nutritionalist can sometimes fall into a one size fits all advice cycle. Ask for alternative food suggestions & other options if the plan or their advice doesn’t fit your food preferences, eating style, food sensitivities, post surgery food intolerances (when your taste buds temporarily change making certain foods disgusting), activity levels & lifestyle.

Relax. You haven’t necessarily affected your weight loss as you will still lose eating 963 calories. Though whether it is right for you at this time is another question. Have a chat with your dietician to review what you’re eating & what is an appropriate caloric goal for you & your needs.

Try sparkling water instead of soda. All the bubbles but no sugar or artificial sweeteners. The artificial sweeteners in the zero sugar drinks could be what’s upsetting you @naynay77. The sugar alcohol ones (any ending in ‘ol’) are the usual culprits.

Lol! All day every day. I found drinking through the night helps. Basically sip every time I get in or out of bed (& because I drink a lot I pee a lot so I drink even more 😁😁). Establishing routines help too. For example I sip every time I get in or out of my car. I sip at every red light. When I worked I sipped every time I started an email & again when I sent one (I had lots of emails). A friend told me recently she plays the drinking game in meetings - every time certain words are said she drinks. (She also said she initially started by drinking whenever someone said something stupid but she couldn’t keep up with the drinking 😂😂😂.) You’ll work out the routines that work best for you too.

I agree with @catwoman7 & @CarmenG. Every food is different so you can’t rely solely on a weight measure or only on a cup measure. When I reached maintenance, I began checking the recommended portion sizes of different foods and then from there I worked out what I could physically eat of that food. Also considered the calories too which also influenced how much I could eat. It’s not perfect but a good place to begin. I eat about a recommended portion size of most foods. For example I eat a little more of vegetables but only about a half a portion of rolled oats. As you likely know, it can differ day to day - some days I can eat my portion & then another I can’t. Have you checked your BMR? Again a good place to start to give you an idea of the calories your body needs based on age, heigh, weight, gender & activity levels. I’d also go back to tracking all your food for a while just to ensure you’re getting in the nutrients & calories you need. I don’t measure & weigh religiously anymore but do random checks to ensure I’m still on track & of course I check any new food I introduce. It can be easy to let things slide or over/under estimate. I was never given calorie goals by my surgeon or dietician only pretty general portion requirements. My surgeon told me to start with 1/4 - 1/3 cup from purée & slowly increase to about a cup by when I reached maintenance. He also drew a picture of a side plate & sectioned off two other circles: protein & vegetables (interestingly no carbs) & said that’s what a meal should look like for me in the future in maintenance. It’s funny that picture really stuck with me & I often think of it when I’m serving a meal or eating out. And using recommended portion sizes as my reference actually does mean my plate looks much like his drawing.

Lyrica, though a wonderful drug for nerve pain, does have the unfortunate side effect of increasing your appetite. My mother’s GP told her straight out she’d never lose weight while she was on Lyrica & her antidepressant & all she could do was work at maintaining the weight she was at. Might be worth a conversation with the insurance company to allow some leeway because of being prescribed Lyrica. Can’t hurt (& get it in writing if they say okay). I wonder if the strict requirements around no weight gain before surgery is more about your commitment to the surgery & wanting to lose weight. Same with any requirement for losing weight (except for the immediate pre surgical diet.) Thankfully our insurance companies in Australia aren’t so strict … yet. No approval requirements from them. Though they are certainly getting more restrictive.

Since you’ve started maybe just keep to one or two shakes a day & have a meal of portion & calorie controlled protein & vegetables/salads for the other meal/s. You’ve started to break some of your sugar & carb dependencies & it seems a waste to throw that away. A two week pre surgery diet is pretty common though some are only on a one or two diet. They can take the form of an all liquid (protein shakes) or two protein shakes & one meal of protein & vegetables or a specific diet of solid food (I was on keto). Just depends on your surgeon. Mine gives different patients different diets depending on several factors including starting weight, weight loss/gain history & medical status. All the best what ever you choose to do.

That’s always an interesting question @Nomorecookies. I always tried to eat (drink) a lot of the excess liquids first then eat the solids. Same with soup. (Actually still sort of do this but I think it is a habit now.) But I also look at it as the milk & the liquid stock in a chunky soup actually are a food too, containing protein & nutrients. I also took ages to eat cereal & soup in the first several months (may be a year 🤷🏻‍♀️) so it was a way of giving the liquids a little time to pass through my digestive system before starting on the solid components. But check with your team to see what they say.

Welcome to the wide & varied pre & post surgical plans. 🙂 I was put on a keto plan before surgery. My surgeon puts different patients on different pre surgical diets. A friend was on the all shake diet & her friend was on the two shakes & one meal version yet we had the same surgeon. I think he does it based on a number of factors: starting weight, pre existing health status, weight loss/gain history, etc. Maybe your surgeon is the same. I wouldn’t be concerned, just enjoy still having a variety of food choices available to you. All the best with your surgery. PS - Best to avoid fruit juice too as it has a high sugar content. Natural sugars but still sugar & calories. It takes several pieces of fruit to make a glass of juice but you would sit down & eat the sane number of pieces of fruit in one go. Plus it lacks a lot of the essential nutrients a whole piece of fruit does. When you can introduce fruit into your diet again go for whole fruit not juice.

Rice, pasta & noodles (& bread) were on my do not eat list. They are highly processed, nutrient poor, simple carbs. They take up room in your tummy stopping you from eating all your necessary protein & other nutrients. I still don’t eat them as they sit too heavily in my tummy, filling me more quickly but that’s me. Generally, the rule of thumb for eating while you are losing weight is to eat your protein first, then any vegetables you are able to eat & finally any complex carbs you may be allowed. Don’t be surprised if all you can eat at some meals is your protein only. There are lots of alternatives to traditional style rice, pasta, etc. Cauliflower rice, zucchini noodles, vegetable pastas (low carb), etc. are options while in your losing phase. Who knows what you may be able to eat (how much & how often) when in maintenance. Best advice is to check with your team.