SpartanMaker

A few things stood out to me about your post. 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. 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. 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.) 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.

What about Milk? Fairlife makes both full fat and reduced fat milk that has extra protein in it. It's not as much as the protein drinks, but it's not that far off. Eggs might be another option? I couldn't tolerate and still don't care for scrambled, but over-easy and boiled eggs have worked well for me for a long time. On the hair loss thing: I don't really think protein intake makes a ton of difference honestly. At least if you are getting the minimum recommended amount per your surgeon. My point is that there are more factors at work here than just protein intake. For most people post weight loss surgery, at least some hair loss is inevitable. Stress and hormone imbalances probably contribute at least as much hair loss post bariatric surgery as protein intake issues. Keep in mind that any hair loss post-surgery is likely temporary, so you'll do yourself well by not stressing over something you may not have any control over. IMO, the bigger reason to focus on protein intake is because it will help stave off muscle loss. This is a bit overly simplistic, but the more muscle you maintain during your loss, the better your weight loss will be because it will help keep your metabolism up.

I wonder if your "weight gain" is actually just edema? Fluid retention, especially around the feet and ankles is a common side effect of many PPI meds. have you noticed anything like that?

So a couple of things here... Regarding hospital stays: Most Gastric Sleeve patients stay only one night in the hospital, but more and more, we're seeing this surgery being done on an outpatient basis. As a general rule, people recover better at home than they do in a hospital, so there's a really good reason to send them home as soon as possible. Gastric Bypass patients tend to stay in the hospital a couple of days, on average. It's just a more involved surgery and the risks of infection, dehydration, etc. are higher. Regarding the question of pain meds: Generally NSAIDS are a no-no after any gastric surgery due to the potential to irritate the lining of your stomach. This pretty much leaves either Tylenol or opioids like hydrocodone or oxycodone. The problem with opioids is that they have a really bad side effect for most people in that they are quite constipating. Because constipation is a really common problem post gastric surgery to begin with, prescribing opioids is just going to make a bad problem much worse. This is not to say that surgeons will never prescribe them, they certainly will if you really need them, but it's never going to be the first line pain med post gastric surgery. Bottom line, you'll probably be fine with just Tylenol, but if you really feel like you need something more, your surgeon may be willing to prescribe something stronger. Just be sure you know what you're in for if you go this route, because you may find the pain from opioid induced constipation is worse than the surgical pain!

I'm 60, but I think you may be asking the wrong question? Although safety is a potential concern at any age, this is something only your surgeon can properly determine. I can say plenty of people in their 70's have had bariatric surgery. I think the real question should be: what are you expecting to be different this time if you have a revision? Would it still be worth it to you if you once again gained all the weight back? In my opinion, the fact that you've gone back up you your pre-surgery weight means that there are other things going on here that you need to address first. If I had to guess, I'd think there are 2 things you need to address before considering revision surgery, GLP-1 meds, or even fat loss diets: Your mental health. My personal opinion is that the virtually all obese or formerly obese people suffer from an eating disorder, or at least disordered eating of some sort. If you don't address this first, you're really likely to out eat any revision surgery you may have. Your activity level. The fact is that most people that are able to successfully lose weight and keep the weight off (surgical or not), are really active. In fact, some studies show that formerly obese people have to be even more active than someone that was never heavy to maintain the same bodyweight. The reasons for that are complex, but if you don't address this, the likelihood of at least regaining a significant amount of weight are pretty high. Best of luck whatever you decide.

Thanks for posting! I don't want to make excuses for my fellow males, but a lot of this is definitely hard-wired. In addition to what was posted here already, don't forget the impact of testosterone. This hormone does a lot of things, but it absolutely has a strong influence on desire for sex. My point is again not to make excuses, but any healthy heterosexual male is absolutely going to look at an attractive woman. What they SHOULDN'T do is catcall, or randomly proposition someone. That sort of behavior is NOT okay.

I agree, but I think it's worth noting that there are multiple types of "Bad Posture", so i think my recommendation would be to see a physical therapist (I think you call the Physios in the UK?). They can take a look at your posture and recommend exercises to address your specific issues.

I wish it were that simple, but it's not. We have to keep in mind that our weight is made up of a lot more than just fat. There are multiple body composition models used, but the one I recommend most people use when trying to lose fat is a 3 compartment model that consists of the following: Fat Muscle Bone I recommend this one since it's easy for most people to visualise those 3 components. Keep in mind however that roughly 70-75% of muscle mass is water. Why is that important? Because sometimes we can be fooled by the scale into thinking we're not losing fat, or that we're gaining fat when we're not. Most likely, what you're seeing is simply changes in water weight. A really common scenario is for people on low calorie diets (like most people here), to see a plateau and think that means they need exercise more and/or eat less, but when they do that, they actually gain a bit according to the scale. The reality is they didn't gain fat, they retained more water. I think it's important to keep in mind that we all have something called a Basal Metabolic Rate (BMR). This is the minimum number of calories your body needs simply to stay alive. It can be thought of as the number of calories you expend per day even if you were completely sedentary. BMR is a complicated subject, but on average, the bigger you are, the higher your BMR. Yes, it goes down as you lose fat, since fat is not completely metabolically inert, but fat loss does not have nearly the effect on BMR that losing muscle does. This is one of the main reasons bariatric patients are told to focus on protein intake because protein is needed to help prevent excessive muscle loss when dieting. More muscle = higher BMR = faster weight loss, or being able to eat more at goal weight The average BMR for women is ~1400 k/cal per day. Higher if you are taller or more muscular, lower if you are shorter and/or have lower muscle mass. Men, for obvious reasons tend to have a higher BMR that's more in the 1700 range. My point in telling you all of the above is that it's highly unlikely that someone eating 900 calories a day needs to eat even less if weight loss has stalled. Frankly, if that is the OP, then I'd actually recommend exactly the opposite: try upping your caloric intake a couple hundred k/cal per day and see what happens. I know it seems counter intuitive, but your body is not a simple machine where the calories in vs. calories out paradigm actually works. Happy to discuss more and provide additional info, but this post is already overly long. Best of luck.

As a bypass patient, there is really nothing that's off limits for me. I pretty much eat anything I want to, just in smaller portions. Some people have to be a bit more careful due to dumping syndrome, but I've been pretty lucky in that dumping for me is really rare. It's happened once in 2 years when I significantly overindulged on pretty much pure sugar with no fiber or protein to moderate things, It was not fun and I definitely learned my lesson! One other thing I'll say is that my tastes have changed. For example, I just don't really want much red meat, so I now eat a mostly vegetarian/pescatarian.

I'd probably bake them into some homemade sourdough bread. Something akin to Whole Foods Seeduction Bread for those that are familiar with it?

I strongly encourage you to seek out therapy ASAP. While surgery will make your tummy smaller and make it hard to eat a lot for some time, you'll eventually get back to a point where it becomes relatively easy to overeat again. Keep in mind that surgery won't fix your head, thus emotional eating like you describe won't go away simply because of surgery.

I'd suggest taking a look at The National Weight Control Registry at http://www.nwcr.ws/. This is a long term list of over 10,000 successful "losers" that have lost weight and kept the weight off for long periods of time. If we dig into the data a bit, a few things seem to come to light as keys to successfully maintaining weight loss: 78% eat breakfast every day. 75% weigh themselves at least once a week. 62% watch less than 10 hours of TV per week. 90% exercise, on average, about 1 hour per day Of course, another thing you'll see in the data is that there really is no one size fits all model for success. While the trends above are helpful for most people, there are people that are successful that don't exercise, that never weigh themselves, and don't eat breakfast. The point is that ultimately you have to find out what works for you.

Post-bariatric surgery hypoglycemia (PBH) is super common. It's one of those side effects they don't seem to ever mention pre-surgery. 🤔 I don't tend to have too much of a problem with it anymore, since I stopped trying to only eat 3 meals a day. As long as I eat every 3 hours or so I'm fine, but too much more than that and I start getting woozy.

I'm going to start with my obligatory recommendation to talk to your surgical team. There is a possibility your issues are complications due to surgery, or even other potential medical conditions. It's better to be safe than sorry and talking with a medical professional can help rule out some issues. With that out of the way, I will give you my non-medical opinion just based on what you posted. Again, just based on what you wrote, it is possible that what you're experiencing is related to the volume of exercise and your low calorie intake. While it's not exactly the same, this is similar to something we call RED-S (Relative Energy Deficiency in Sport). Feel free to Google that to get an idea of what I'm talking about. Both in the case of RED-S, and what you're describing, it sounds to me like your body is telling you that you're overdoing things. I love that you're being more active, but without properly fueling your body, you can actually cause some nasty problems (again, see RED-S). Keep in mind that your body actually only improves physically during recovery, which includes both proper rest and proper nutrition. Dehydration can also exacerbate the problems your having. Plus, while dehydration can always be an issue for anyone, for someone so soon after bariatric surgery it can be really problematic. One of the most common reasons bariatric surgery patients end up back in the hospital is due to dehydration. My advice would be to give yourself a down week from the exercise, which should do a couple of things. One, it will give your body a chance to recover some, which is a good thing. Two, it will help you know if this really is due to the volume of exercise and the incredibly low calorie intake. By the way, a down week, does not need to be a week completely off, Just stepping things down 25% to 35% is enough. For example, instead of walking 5 hours, shoot for 3 or 3.5. Do the same on your swimming. Taking a down week like this around once a month is really common for even pro-level endurance athletes. I promise it's going to help and not hurt you in any way.

Don't be afraid to talk to your surgical team about the constipation as well. It's super common post surgery and they should have a lot of experience with treating it. They should be able to help you find the right combination of medication/supplements to help you out.

Medical questions should really go to your surgical team.

Give yourself time! When you press the brake in your car, it takes time to come to a complete stop. The same is true when you try to go from losing to maintaining. It's hard to know immediately if you are eating the right amount, especially with a significant amount of exercise like you're doing. As you are learning, you've got to EAT to fuel that level of activity and it can be stressful for us formerly fat people to eat at levels that at one time would have led to weight gain. Track things for a month or so and see where you end up. If you continue to lose, then you obviously need to eat even more. If you seem to be maintaining within a few pounds (keeping in mind normal fluctuations), you're probably where you need to be. If, heaven forbid, you do start to gain again, just ease off a tiny bit on the calories and you'll stabilize. Whatever you do, don't stress it, because you now have all the knowledge and tools to stay at the weight you want!

You've gotten some good advice already, but reading your post, a few things stood out to me. These are in no particular order: 1200 calories sounds high for 15 weeks post-op, but if that's what your plan calls for, who am I to question it? I think the bigger question is does this 1200 number include all the alcohol? One of the reasons alcohol is not recommended post bariatric surgery is that it's got a ton of calories and will definitely slow weight loss. The other huge concern on alcohol is that a substantial number of post-op patients develop alcohol use disorder. (Some estimates are as high as 20% or even 30%.) You didn't actually specify how much you drink, but when I see "active social life", I interpret that as "I drink a lot". Maybe try drinking non-alcoholic drinks when you are socializing? If you find that you can't give it up the alcohol, this is a major red flag and you really need to seek help. Taking another approach here, I noticed that you are being more active, which is fantastic! I did want to make sure you knew that changing your activity levels like that (starting a couch to 5k plan), will cause your body to retain more water. This means you may not see the results you are expecting on the scale, even if you are still losing fat. Keep in mind that the your weight is made up of lots of things other than just fat, so variations are normal and are just part of the process. If you are eating less than you burn in a day, then you are 100% burning off fat reserves, even if the scale does not show it. Best of luck.

Just finished a Half Marathon in ~2:10. Not too shabby for an old man that had a total knee replacement and open heart surgery, and that used to weight >330 lbs a couple of years ago. That's all, thanks for indulging me! 😀

Well, great is sort of relative isn't it? 😁 For me it's much better than I expected this week, all things considered. I'm sure for some it's pretty slow. Consider that the world record half marathon time is about 58 minutes. This means I'm running twice as slow as those folks. On the flip side, this time would probably put me in about the 55th to 60th percentile world-wide for my age group. This means I'm probably a little faster than average, but I'm sure not winning any races! I've got another Half Marathon race scheduled in November and hope to break 2:05 in that one. I haven't fully decided yet, but may do one in April or May and if so, will be shooting for a sub 2:00. I guess my point is I don't think too much about how I compare to others. My real goal is to continue to beat myself!

Are you logging your food? If you end up working with a dietitian, I can almost guarantee they are going to ask you to do so. You might as well start ASAP so they have something to work with. Specific amounts matter, so be sure to weight and measure everything. The reality is we just aren't good at determining how many calories we actually eat. Most people underestimate calories, but overestimating isn't unheard of either. You mention a couple of times that you're eating a lot. What you need to understand is that the amount of calories you are currently eating just IS NOT ENOUGH for you. You need to be consuming eating even more calories and logging your current intake will often be the first step. Once a baseline is established, a dietitian can help you find ways to increase your caloric intake to where it needs to be, even if you feel like you can't physically fit any more food in.

Have you tried smoothies? I find even with my restriction, I can down 500-600 calories in smoothie form, vs maybe 300-400 cals of most other things before I'm full. You can load it up with fruit, peanut butter, protein powder, etc. to suit your tastes.

I don't know if this is your issue or not, but one thing I've seen from others in a similar situation is that they still eat like fat people trying to diet. If that's you, you need to completely change your mindset. Your job at this point is to GAIN weight, so dietary fat and carbs are your friends. A key change would be to look for and eat more calorie dense foods like rice, potatoes, peanut butter, full fat dairy, etc. If you eat meat, look for fatty meat, not lean cuts. Calories are your friends right now. Just my .02.

A few things to think about here: It's not all fats that raise cholesterol, it's primarily saturated fats and trans fats. While people often think about the saturated fats found in meat and dairy, they aren't the only sources. Also, trans fats are found in lots of processed foods, so these can sneak in to your diet from things like store-bought baked goods. Stress can raise both LDL cholesterol and triglycerides, so actively working on stress reduction can have a positive impact on total cholesterol. Moderate to high-intensity aerobic exercise can lower cholesterol levels quite a bit Some research also indicates that low- to moderate-intensity resistance training can help reduce total cholesterol, but the link here is not as strong as it is for aerobic exercise

Rocking it! I love that your "after" photos are all in the gym. You're obviously working hard and it shows!