SpartanMaker

Don't forget prebiotics too! These may be even more important.

Sorry you're dealing with this. Sounds like your team has ruled out most of the physical issues. but I wanted to throw a few more things out there that might be worth considering: Have you ever been evaluated for sleep apnea? This disease can absolutely wipe you out physically if left untreated. It would be odd for it to start post-surgery, but maybe it was masked before for some reason and you've had it for a while? Obviously eating a severely restricted diet means you're not getting a lot of calories in. Now this is as designed to drive weight loss, but your body should adapt to that and use fat to fuel your cellular processes. This should mean, if everything is working properly, that you get plenty of energy from the chemical decomposition of fat. Depending on what specifically you're eating, there could be something going on diet related here that may not have that process working as designed. Your gut microbiome is often overlooked as a source of issues, primarily because it's not well understood by physicians. What I mean here is that it's possible you don't really have the proper balance of good bacteria in your gut to deal with what I assume has been a significant shift in how you eat. At the very least, adding in both prebiotics and probiotics could help shift your microbiome in the right direction. This one will sound bad, but it's possible this is psychosomatic. If you're not familiar with the concept, the mind is an extremely powerful thing and can absolutely make you feel like you're exhausted, even when there's no physical cause. This does not mean you're crazy, or faking it, or anything like that. The physical manifestations of psychosomatic illness are very real. FYI, stress is a huge driver of this process, so working on stress reduction would be a good first step. If needed, there are even doctors and therapists that specialize in treating psychosomatic diseases.

Well, since you wanted things to read: https://pubmed.ncbi.nlm.nih.gov/1333426/ Yes. people even study how much poop weighs.

Sorry ahead of time, this is going to be a long post! Let's talk a bit about what causes stalls/plateaus: The most common reason for any stall (including the dreaded 3-week stall), is simply that you are retaining more water. There are a few reasons this happens, from hormonal shifts, tissue repair, illness, or changes due to glycogen vs. ketone metabolism. This post would be even longer if I spent too much time here, but suffice it to say that for many people (especially early in the process), they are just retaining water and not actually failing to lose fat. As you lose more weight, your overall metabolic rate will slow down. People sometimes think fat is not metabolically active, but that's not true. Losing fat means your metabolism slows down, even if you retain the same amount of muscle mass (which most people don't). This means that as you lose weight, it takes less effort to move or even just live, so the amount of calories you burn both during exercise and just living also drops quite a bit. On the intake side as you progress after bariatric surgery, you'll be able to eat more. This isn't a bad thing and is by design, but obviously you should be able to see the problem here. Your metabolism has slowed down and now you can eat more. This can lead to you basically eating as much as you're burning. When that happens, weight loss stops. Especially if you're not tracking intake closely by weighing and measuring your food, you can easily be eating a lot more than you think. Some studies have shown people underestimate caloric consumption by several hundred calories on average. This is more than enough to cause a stall. This one may be TMI for some, but you may simply be retaining more stool. Feeling constipated? That will definitely impact your weight. This is going to be hard for some people to hear, but I can tell you one thing it's not, and that's hormones. Yes, various hormonal processes negatively impact weight loss in a myriad of ways, but they don't overcome the basic fact that if you eat fewer calories than you are burning, you'll lose weight. What these hormones can do if they're out of whack, is bad things like slowing your metabolism even more, increasing your hunger, screwing with water weight, or even fooling you into thinking you're eating less than you are. So, that's all great, but what do we actually do if we're in a stall? Well, I think it depends on when it happens and how long it lasts: If it's early (a.k.a. the 3-week stall), just keep doing what you're doing and you should be fine. I know people don't like that advice, but as I said it's just water, so don't worry about it. Later on, especially if the stall is lasting longer than 2-3 weeks. that's when I think it's important that you look closely at what you are actually burning, as well as really tracking what you are eating. If you don't know your RMR (Resting Metabolic Rate), you should. The closer you are to goal, the harder it is to get the balance right between intake and output to make sure you're not eating too much, so fixing this starts with knowing your RMR and accurate food logging. There's a lot of anecdotal advice thrown around about "ways to break a stall", but there seems to be little scientific evidence for any of it. It certainly won't hurt to try things like breaking up your routine in terms of diet or exercise, but just understand that this change may or may not have any impact. If it makes you feel better to be proactive, go for it. Longer term, there is one piece of solid advice that's backed up by lots of research: Even if you don't really like working out, do it anyway. Those WLS patients that make a regular habit of exercising for 45 minutes to an hour most days a week are significantly more likely to reach their goal and maintain the weight loss. (One caveat here: significantly changing your exercise routine can make you retain water and possibly even add muscle, so don't freak out if you see a stall or even a gain.) I'll take that exercise advice one step further and say you really should be doing some form of strength training. This is also backed up by lots of studies, but the great thing about strength training is that it makes your burn more calories even at rest (in other words, it increases your metabolic rate). There are lots of other benefits, but the metabolic benefit is the most germaine to the stall question. Those that do strength training are less likely to stall during weight loss and are more likely to reach and then maintain their goal weight long term.

I guess I'll be the lone voice of dissension. That's fine, it won't be the first time! While this is does not seem to be causing you any physical issues, I have to wonder about if there are psychological impacts? The words you chose to describe this " I have found myself becoming obsessed" have me worried about transfer addiction. Addiction in any form, even if you can't see the physical downside, is still addiction. Perhaps it was just an unfortunate choice of words on your part, but since transfer addiction is a real concern for all of us, I think it's worth being aware of this possibility. Some signs you may want to seek help: Inability to stop Always wanting more Participating in this behavior despite negative outcomes (Job, physical/mental health, relationships) Denying that there is any negative outcome, or trying to cover up negative outcomes Constantly thinking about this addiction If any of those ring true, please seek out help. Otherwise, enjoy your new hobby!

OK folks, I really need some humor right now! Let's see those funny GIF & Memes related to weight loss & weight loss surgery! I'll add a few to get us going:

For what it's worth, I self administer testosterone IM every other week. My bariatric team had a blanket statement that patients should not get any shots 2 weeks before or after surgery. I assume this is due to the increased risk of blood clots. I specifically asked about the T shot and they told me it was fine to continue. I agree you should ask your team though, because every doctor is different. It would suck to be told you have to reschedule the surgery because of something dumb like this.

Hey folks, I have 3 different trips coming up and would love your suggestions for food while traveling? I'm about 6 weeks out and have no food restrictions, though I obviously can't eat all that much yet. I'm mostly focused on protein, with some good carbs and fats mixed in where I can. One trip is by car ~ 9 hours each way, 5 days total. This one has me worried about what to eat on the drive days other than stuff like yogurt and protein drinks? I can probably stop and pick up food if needed, but this is through mostly rural areas and options are pretty limited. The other days I'll be in a hotel room with a kitchenette and will have good access to grocery stores and restaurants. I expect I'll be able to eat more normally on those days. The next trip is an overnighter by plane. I may live mostly on protein bars for this one unless anyone has any good suggestions? Unfortunately, no kitchenette this time, so I'm mostly stuck with what I can bring on the plane, what I can find ready-to-eat at grocery or convenience stores, or eating out. The final one is 4 days, again by plane. Different city than trip 2, but should have good access to stores & restaurants. Again, no kitchenette, so no cooking.

On my plan, I was instructed to start the 30 min before and after thing only when I started on solid foods. It was not needed or even suggested on my plan when I was on full liquids. The explanation was that it's all liquid anyway, so there's little reason to do this. Your plan may have handled things differently, but just wanted to provide my experience.

I love this! I never thought about it that way, but it's a great motivator!

Awesome job! You are an inspiration to many of us, so I'm thrilled you're still here and posting! I wish more veterans stuck around too. I'm hoping I can, but life has a way of taking us all to different places.

The current clinical practice guidelines that pretty much all insurance companies use (assuming your insurance even covers bariatric surgery), consist of the following: BMI of 40 or higher, OR a BMI of 35 with at least one of the following comorbidities: Clinically significant cardio-pulmonary disease (e.g sleep apnea or OHS) Coronary artery disease or Cardiomyopathy Coronary hypertension (high blood pressure) Type 2 diabetes Some also consider: hyperlipidemia NALFD or NASH GERD Asthma Venous stasis disease Severe urinary incontinence Debilitating arthritis Your best bet will be to talk to your surgical team as they can help navigate your specific insurance.

In general, I'm not a huge fan of pedal exercisers, but especially the low cost ones. They just are not very stable, which makes them quite jerky when you use them. Look for heavier ones with a nice wide base to overcome this tendency. Note that there are basically two types of pedal exercisers. One (like the one you show in the photo), is supposed to mimic an elliptical machine. The other type mimics an exercise bike. I'm not a fan of ellipticals at all, but especially for someone rehabbing from a knee replacement, I believe they should be avoided. The elliptical motion itself is not a natural movement, and it forces you to over engage your quadriceps muscles. This can put extra stress on your quadriceps tendon and patella and cause pain. This also can create muscular imbalance (overworking your quads and not your glutes or hamstrings), leaving you more likely to injure yourself. If you are determined to get this type of machine anyway, at least make sure it also allows you to go in reverse as this will help address the shortcomings above. It probably should be clear by now, but I personally think a better choice would be a traditional "bike-like" pedal exerciser. This is a more natural motion. I should note that If you're going to Physical Therapy post surgery (and hopefully pre-surgery as well), then you may not need to buy anything. Once you're through with PT, you should be fine walking. Walking is the best exercise you can do post surgery, since it's what our bodies were meant to do. If you do decide you need one, DeskCycle is probably the best known brand and likely the only one I'd personally buy if I were shopping for one. Just my thoughts and not meant to dis anyone that loves their elliptical.

I didn't have to do that either and I had bypass. It may depend on how severe the preop diet was? Mine was 2 weeks long and full liquids only.

Just for the record, lots of other manufacturers also make Magnesium Citrate. Vi-Jon mostly makes store-brand stuff.

I recently posted on this here:

Adding another one:

I'm curious how much you're exercising? This may sound counter-intuitive, but, getting regular exercise may actually help you have more energy. Also, I think you'd be better off getting a bit less protein and more water. Dehydration can really sap your energy, but 70-90 grams of protein may be more than you really need at this point?

Bottom line, no. Keto is a high fat, moderate protein, low carb diet. Post-surgical diets vary a lot, but almost all of them emphasize protein first. Most also emphasize low fat and low to moderate carbs. In maintenance, lots of folks eat a more normal diet, eating a balance of protein, fats and carbs.

I agree with @GreenTealael 100%. Your bariatric team is in the best position to help. We here on the forums really know nothing about you. To start with, your profile isn't filled out, so we don't even have basic info. Beyond the basics like starting weight, goals weight, current weight, age, gender, and height, I'd ideally need to see your food log, and would have your percentages of body fat and lean mass. Finally, I'd want to understand what you mean by "I work out 6 times a week for over 50 mins". Exercise type and intensity make a ton of difference here. Even those things might not be enough though and that's where your bariatric team can help. There is one universal truth if you're not losing weight: You are eating about the same number of calories as you're burning. Without some potential metabolic and endocrinological testing that your doctor can do, it would be hard to know if this is due to Eating more than you think Burning less that you think in exercise A slow metabolism due to the loss of lean body mass Maybe even a hormone imbalance As pointed out, the simplest place to start is making sure your are logging your food accurately. It's really easy to be off by several hundred calories and this can easily be enough to make a huge difference in how much you lose.