Quixotic

Hello, all. I was "sleeved" on Nov 18. I lost a lot of weight preceding the surgery (40 lbs) thanks to Phentermine. Then I lost another 15 pounds in the week around the surgery because those Protein drinks (isopure) are only 160 calories each. But once I started in on Soups in phase 2, I just stopped losing and haven't lost a pound in the last two weeks. In fact, I gained 3 pounds. I feel hungry a lot and can eat nearly 2 cups before my body says "stop" (hiccups are the warning). Is that normal? I don't want to overstress my stomach but also expect the surgery to help out in the portion control. Since I lost so much before, I'm not too worried, but I'll be concerned if I don't start losing again soon. I suspect that the problem is that liquids aren't constrained by the size of the new stomach, so I can eat more before feeling "full." I also suspect that the weight gain is just recovery from the surgery, not a gain in body fat. But I don't know what to expect. Anyone else able to eat more than they thought a 60ml stomach should hold? Any advice about portions and hunger management? Anyone else gain weight after surgery? How long did it take until you started losing again? Thanks for your comments.

Hang in there. I had a weight gain, too, and worried about my sleeve being too big. In fact, that was my initial post. In my case, it turned out to be the type foods I was eating. I've seen the term "Sliders" used for foods that can leak around the sleeve, allowing more than the usual capacity to be eaten. If you are eating that sort of food - liquids or soupy, soft foods - you may defeat the size of your new stomach. I could eat a ton of yogurt and frozen berries, for example, without feeling filled up. Also, if you are eating foods high in fat (cream, especially), starch (like potatoes) or sugar (Fruit drinks, for example), you can defeat your new stomach. You can't go back to french fries and expect the weight loss to continue. But if you stick with low fat Proteins (eggs are not low fat - about 75% of the calories in an egg is from fat) - try for things like chicken breast without skin, white fish, egg whites, whey Protein isolate, etc. and lots of low starch vegetables, you may find that you fill up on much less food. I've heard that you can stretch your stomach if you keep drinking soft drinks. The air will expand the stomach (not to mention the sugar in the drink). Lastly, and this isn't scientific, I've read and suspect it's true that if you wash your food down with drinks, it may also allow you to eat more. Exercise is something that I've found is key. Housework isn't enough (and housework won't help calm your nerves, as walking will). I used to think walking was boring, but that was before I got a Kindle and could read while I worked out on the elliptical or treadmill. Now it's just part of my routine to do 45 minutes a day, every day, while reading a book. Good luck. Don't give up on yourself!

A quick postscript to the excellent comments. I had a followup with my surgeon's office. I was going too fast on my return to normal food and quantities, as everyone suspected. It just took a week or so for my "new" stomach to read me the riot act. But I'm back on track with softer foods and smaller volume. As for the weight gain, the nurse pointed out that I need to look at the big picture, not just one time period. I lost 18 pounds in the last month (including the weight gain), which is more than they really think is ideal (for me). The fact that I dropped 20 lbs the first week (right around the surgery) meant that the weight gain afterward was just re-hydration and regaining muscle tone. I was just so hungry after the week on IV and Isopure that I moved too fast.

Hello, all. I was "sleeved" on Nov 18. I lost a lot of weight preceding the surgery (40 lbs) thanks to Phentermine. Then I lost another 15 pounds in the week around the surgery because those Protein drinks (isopure) are only 160 calories each. But once I started in on Soups in phase 2, I just stopped losing and haven't lost a pound in the last two weeks. In fact, I gained 3 pounds. I feel hungry a lot and can eat nearly 2 cups before my body says "stop" (hiccups are the warning). Is that normal? I don't want to overstress my stomach but also expect the surgery to help out in the portion control. Since I lost so much before, I'm not too worried, but I'll be concerned if I don't start losing again soon. I suspect that the problem is that liquids aren't constrained by the size of the new stomach, so I can eat more before feeling "full." I also suspect that the weight gain is just recovery from the surgery, not a gain in body fat. But I don't know what to expect. Anyone else able to eat more than they thought a 60ml stomach should hold? Any advice about portions and hunger management? Anyone else gain weight after surgery? How long did it take until you started losing again? Thanks for your comments.

You are doing terrific and you obviously are thinking things through carefully. Don't let the scale control your decision making. If you do as you describe, and exercise every day (walking), the weight will melt off. Just not when you are weighing yourself expectantly. And not if your diet has fat, starch or sugar in it (even fruit) somewhere. That's my experience, anyway. As for veggies, I cook a lot of frozen vegetable medleys (plain, no butter), such as peas and carrots or those two plus corn and green Beans. For flavor, I may add some low sodium chicken stock (taste it first. Some stocks taste great but lots of them don't). Also I often add black beans, lentils or kidney bean for Fiber. The usual admonition is to introduce new foods gradually to see how well you tolerate them. I do great with some beans, but others might not. Good luck!

To HetKF: That's an amazing result. However, weight loss that fast sounds like muscle loss and dehydration as well as fat loss. I lost a huge amount in the 10 days around surgery when I was hardly able to move, but I don't think it was all that healthy. I felt weak and my face looked gaunt. So when I started on soft food, I tried to eat as many pureed vegetables as I could along with the protein. When I was able to go back to the gym, my suspicions were confirmed that I was much weaker than before. So I focused on getting back up to my previous exercise level (weights and aerobics) even though that nullified some of the weight loss from calorie restriction. My waist did get smaller even though I didn't lose weight for almost two weeks. I read about people that are in the soft food phase eating cheese and drinking apple juice or other sweet drink. That just can't be good. And by the way, I was told that you need 100 gm of protein, especially right after the surgery, for tissue repair. If you aren't getting enough protein, that could lead to muscle loss and a slow recovery. Your surgeon's comment has me worried for you. Telling you that you should lose 21% (about 50 lbs) in a month is setting you up for disappointment and might induce you to do something unhealthy. I heard that the most you can expect to lose is about 4 lbs per week if you do everything right. If you lose 15 or 20 pounds in a month (and don't lose muscle or get dehydrated), you should be thrilled and pat yourself on the back. If anyone has better knowledge of how much we should be able to lose in a month, please add your comments.

I think you (and your NUT) are 100% on target.

Thank you, Divajksn. For those looking for dietary information, I recommend The Complete Idiot's Guide to Eating Well After Weight Loss Surgery (which I downloaded to my Kindle from Amazon). I also had many nutrition classes I had to attend (and tests I had to pass showing I understood the guidelines). I suspect pre-surgery prep is a strong factor in response to surgery and post-surgery diet. I had to go through a strict diet and education program to qualify and was already 50 pounds lighter by the time I got home from the VSG surgery. I hated the wait, but it ended up being time really well spent (to my surprise). I do follow the guidelines set for me, but they don't seem as restrictive as the ones I read from people on this Forum.

To THINONEDAY (soon), I don't know the size bougie used on me, but it's pretty clear it was larger than the ones used on most everyone else. Either that, or my stomach had greater elasticity. I have a followup next week and I'll ask. I do find, as TijuanaPlication suggested, that "soft foods" and liquids go down easier and may be consumed in larger quantities than solid food. Now that I eat foods like fish, I can't consume as much as before without feeling really full. I suspect the quantity tolerance also is much less for foods with lots of fat in them. My diet is really low in fat (and no breads). SO I can eat more. (The preceding doesn't explain why Dansha is challenged even by cottage cheese, though. Is it non-fat, Dansha?) To answer the question about my diet instructions, it was basically 10 days on liquids, a week on baby foods or Soups, then a week on soft foods. That 3-4 week period is supposed to take care of my regimented diet and limited exercise phase. After that, I'm supposed to just "be careful" and stop when I feel uncomfortable. I've seen a lot of different dietary instructions for sleeve patients - much more variability than seems necessary - but I've also seen a wide range of patient tolerance, from those that are eating "normally" after little more than 2 weeks to those that are still restricted after several months. Also, I've seen some widely different limits placed on activity. My instructions were to keep it light (except lots of walking) until 4 weeks, then proceed with more rigorous exercise, even free weights and the stairmaster, as my body permits. I follow the spirit of the instructions and just listen to my body, which has kept me out of trouble so far. Thanks for the good comments.

Thanks for those helpful comments. I do take a PPI (Prevacid). But I had no idea that the nerves in the stomach could have been affected, nor that it could affect my sense of feeling full. I'd better be more careful.

I eat just about anything (now three weeks after being sleeved). I don't eat red meat for health reasons (I didn't before, either) and don't eat raw veggies for now because I'm afraid the Fiber will get "stuck." And I stay away from "fattening foods." But I can eat about 2 cups of "soft" food before feeling full. If I eat chicken and cooked vegetables, about a cup or cup and a half. I eat cooked Cereal (oatmeal or cracked wheat) for Breakfast, plus some Protein source like Isopure. During the day, I eat lots and lots of cooked veggies (I like veggies), fish, chicken, shellfish and a little fruit (not too much because of the sugar content) and Greek yogurt (yum!). I often supplement with whey Protein (isolate). I'm surprised to hear how many people like Dansha have so much trouble eating. I've had a couple of bouts of nausea if I overdid it, so I know the sleeving was real, but otherwise I've been lucky with my recovery (including an hour a day in the gym on the elliptical plus some light weights). I'm so normal, I just hope I can still lose weight! Good luck to you, Dansha, and you, TijianaPlication. For what it's worth, I didn't do well with WW because they allow too much starch and fat. I may eat too much, but as long as it's chicken breast, fish and veggies (I avoid starch), I have still been able to lose weight.

Lots of great comments on this topic. Here are some things I have found to be helpful. First, I told people at work I was having surgery for a hernia (which is true. My surgeon took care of an hiatal hernia at the same time I was sleeved.). That solved the problem of explaining my absence from work. As for the people around me, I preempt lots of comments by volunteering the information that I just lost 20 lbs with a low fat, high Protein, high exercise diet. That's true, except that it was lots more than 20 lbs and the sleeve helped me follow the program. But it is better to say you are following a diet program than feed their curiosity by saying nothing. My last comment is to remind everyone that VSG does not remove fat, it only helps control appetite. So ultimately, it's the good decision making and discipline of the VSG recipient to cut back on fat, sugars and calories, not the surgery, that produces the result. We all should pat ourselves on the back for enduring a bit of hell to make weight loss successful. Good luck to all of you!