Struggling to keep weight on?

[It's all new 453]

I am struggling to find anyone else for support who is in a similar situation - whether it is because I am a rarity or that those of us with this issue don't frequent the support forum... I am not sure. I am getting frustrated over time and tired of working hard not to lose weight. I would never have expected this to be a problem! I had my surgery in May 2012 at 255 lbs and have been at goal for a bit over a year.

I am currently struggling with a recurrence of depression, so the energy that I have typically been putting into getting all of my calories and exercise is flagging - I am getting treatment for the depression but it takes some time. I have worked very hard not to lose weight during this time and to keep my calories up. Typically I am very, very active. I expect that within a few weeks I will be feeling enough better to be back to exercising more. I usually exercise about 15 hours per week, taking one or two days off. Usually at least one day per week I get four to six hours of exercise, even as much as eight hours. I am an avid cyclist, hiker, skier, etc.

My problem seems to be that I have a very high BMR of 2,000. So, I need at least that many calories on days with no exercise. Then, add exercise and I have days where I need 5,000 and even up to 7,000 calories in order to maintain my weight. Obviously those super high calorie days are rare, but I regularly have 3,000+ calorie days.

Typically I am using lots of whole milk (at least 750 calories of whole milk per day) and on days when my weight has dropped below my comfort zone I start adding heavy cream or half and half. I also eat avocados, nuts, olive oil, butter, premier Protein shakes, etc. I also make green shakes - blended Protein powder, Greek yogurt, fruits, veggies. I use chocolate on days when I am desperate for more calories but don't have more room for real food - it's a total slider. I probably get minimum 1,000-1,300 calories from liquids and the rest from solid food. I have to choose the highest calorie foods out there - looking at a menu I will intentionally choose whatever has the most possible calories. My goal is to maintain at 130 when not working out and up to 135 if I am working out a lot. I was at lower weights initially (down to 123 at 5'6") and looked way too thin. At the lower weight I had too little muscle, was a size 0, and was told that I looked like a victim of weight loss. It wasn't a kind thing for someone to say but was accurate - at just a slightly higher weight I look far healthier and more proportionate. I am on the mobile app and have not updated my ticker from my lowest weight probably - but that is where I am at today and what I have decided is healthiest for me. It took a lot of effort to add muscle weight.

When I was obese I didn't exercise and I am sure my metabolism wasn't this high. But now that I have lost the weight I worry that I will be thinner, fit, and set myself up for the same health problems by eating unhealthy foods in order to maintain my weight.

I hear that weight gain is common at the 3 year mark. I also worry that the way I have to eat now in order to maintain my weight could set me up for problems later on. I currently weight myself regularly to make sure I am not losing weight rather than to make sure not to gain, though.

I think if the depression would improve I would have more energy to pursue healthier high calorie food options. Looking for suggestions and other people in the same boat...

[deedadumble 1,033]

Have you had your thyroid checked? Also, that is a lot of exercise (I'm running a half marathon on Sunday and I thought I exercise a lot!). Cross addictions are extremely common for WLS patients. I'm not suggesting that you are because I don't know you, but maybe something to explore with a therapist. Peanut Butter is a good, high calorie snack.< /p>

[NMJG 1,266]

Might be a good idea to make an appt with your doctor, run some tests, talk to the nut, visit a theraptist, etc. IMHO you sound like you may need professional help now, not just our two cents. Good luck to you.

[It's all new 453]

I have had my thyroid checked - I have hypothyroid that is regulated into the normal range with meds. I've also had other lab work. In terms of exercise I am not at the gym working out obsessively, I am outdoors doing things that take long periods of time. In order to ride a century ride it is necessary to train for long periods of time, in order to take long hikes it necessary to take longer hikes for training, and skiing and snowshoeing also are endurance activities. I am slow paced, and these are endurance events. I also lift weights just a few hours per week in order to have better strength for so many things - like chopping wood, for example. My physician and therapist and WLS are all on board with the quantity of exercise. I have also been to a specialist in sports exercise performance/nutrition etc. and have had my VO2 max tested, know my calories burned at different heart rates, etc. I strive to keep up with this stuff and make sure I am getting the calories I need for my activities. I do catch flack for the quality of my nutrients though! I appreciate the concern. I am hoping to find some other people who have to work to keep their weight on and get some new ideas for how to make it happen.

[feedyoureye 3,087]

I am not near as sporty as you, and don't have the same problem as you... but was told by my Dr that depression comes with the WLS often. So I keep an eye out for it, and do feel that way sometimes too... with anxiety. Hopefully with the resolution of that, your routine will get back to normal. It would be very hard for me to eat 3000 a day, of good quality food, thats for sure! I eat up to 1600 on days that I exercise, and it feels like a feast! Perhaps weight gain shakes? Spacing out your meals to fit more in? Good luck with that, it sounds like a challange.

Perhaps Butterthebean can chime in here, he runs a lot and seems to keep things in check...

[mistysj 1,940]

I'm not a vet but please don't flog me for replying. It occurred to me that most of us are eating very low carbs because carbs seem to make it easy for us to gain or keep weight. It occurs to me that you are getting your extra calories from mostly Protein and fat, just like a good WLS patient! Protein and fat don't get turned into body weight as easily as carbs. I think you need to add some good carbs back into your life. Whole wheat bread or oatmeal or Cereal or mashed potato every once in a while might really help, as long as they don't awaken the carb monster.

And thank you for sharing what must be uncomfortable to share here where most people are not in the same headspace as you. It is good to know all of the different possible outcomes.

[CowgirlJane 14,259]

While the nuts and a few other things have carbs I have to agree with misty-if I wanted to gain 5# I would start with Pasta,potatoes,bread and fruit. Those are all relatively healthy foods that pack weight on me. Add Peanut Butter, trail mix and a little ice cream for dessert(not healthy but even small quantities does wonders in terms of weight gain) and I would be gaining.

Prior to my plastics I often did 4-8hour activities like hiking or riding my horse through the mountains etc. and my"survived the Irish famines genes" kick in and make me hungry and metabolicly efficient. As in,did not make me lose too much weight. I would love to have the bmr testing done but assume it is too costly given I don't really need to know.

Good luck at finding a good balance. I commend you for focusing on ideal health and living an active life -this is why we did the surgery!

[It's all new 453]

While the nuts and a few other things have carbs I have to agree with misty-if I wanted to gain 5# I would start with Pasta,potatoes,bread and fruit. Those are all relatively healthy foods that pack weight on me. Add Peanut Butter, trail mix and a little ice cream for dessert(not healthy but even small quantities does wonders in terms of weight gain) and I would be gaining. Prior to my plastics I often did 4-8hour activities like hiking or riding my horse through the mountains etc. and my"survived the Irish famines genes" kick in and make me hungry and metabolicly efficient. As in,did not make me lose too much weight. I would love to have the bmr testing done but assume it is too costly given I don't really need to know. Good luck at finding a good balance. I commend you for focusing on ideal health and living an active life -this is why we did the surgery!

So, I got my BMR testing and VO2 max testing at Seattle Performance medicine. I saw a great doc, and was very happy with the info they provided. It helped me because I had been taking in far fewer calories than I needed to support my activity based on my WLS telling me I would have to stick to a 1,200 calorie diet the rest of my life. Given that my BMR is about 2,000 that wasn't working well for me! It was maybe $350, and while that is a lot of money for my budget it was really worth the information I received. I got heart rate training recommendations, found out I had been overtraining (just pushing my heart rate a bit too high to properly improve performance), and learned how to figure out the number of additional calories I would need each day based on my heart rate during exercise.

When I eat solid foods I do tend to choose a lot of high carb options - I try to balance so that my plate looks like 3/4 carbs and 1/4 Protein by volume. I still get in enough Protein each day given the milk I drink and the number of meals and Snacks, and then I eat a lot of high calorie carbs - mashed potatoes with heavy whipping cream and butter, or a part of a roll with butter, and then I bake Cookies and apple crisp and eat them with ice cream as a snack later in the evening.. It sounds kind of awful... but if I didn't do those things I would lose weight that I don't want to lose. I get in my fruits and veggies as liquids in my green shakes that I make.

I appreciate that you understand that the activities I am choosing are part of an active lifestyle - and by their nature take long periods of time. Similar to a trail ride, they burn lots of calories at lower heart rates over many hours. But the joy is in the things you do and see over those hours! There are some beautiful places in the Pacific Northwest. Thank you for the suggestions!

[CBT 450]

So, I got my BMR testing and VO2 max testing at Seattle Performance medicine. I saw a great doc, and was very happy with the info they provided. It helped me because I had been taking in far fewer calories than I needed to support my activity based on my WLS telling me I would have to stick to a 1,200 calorie diet the rest of my life. Given that my BMR is about 2,000 that wasn't working well for me! It was maybe $350, and while that is a lot of money for my budget it was really worth the information I received. I got heart rate training recommendations, found out I had been overtraining (just pushing my heart rate a bit too high to properly improve performance), and learned how to figure out the number of additional calories I would need each day based on my heart rate during exercise. When I eat solid foods I do tend to choose a lot of high carb options - I try to balance so that my plate looks like 3/4 carbs and 1/4 Protein by volume. I still get in enough protein each day given the milk I drink and the number of meals and Snacks, and then I eat a lot of high calorie carbs - mashed potatoes with heavy whipping cream and butter, or a part of a roll with butter, and then I bake Cookies and apple crisp and eat them with ice cream as a snack later in the evening.. It sounds kind of awful... but if I didn't do those things I would lose weight that I don't want to lose. I get in my fruits and veggies as liquids in my green shakes that I make. I appreciate that you understand that the activities I am choosing are part of an active lifestyle - and by their nature take long periods of time. Similar to a trail ride, they burn lots of calories at lower heart rates over many hours. But the joy is in the things you do and see over those hours! There are some beautiful places in the Pacific Northwest. Thank you for the suggestions!

I just entered maintenance. I had a plastics consult and she told me to stop losing weight. I'm glad she did; still, I too have a high BMR closer to 3k. Measured regularly by the endocrinologist. I'm about 3 months overdue to meet with him :-/

About 7 pounds ago I thought I probably could stop losing. I just thought my body would figure it out. I keep losing. I think my sagging skin confuses my judgement.

About food: if I want it, I eat it. I don't like the taste of fatty foods anymore. I too eat avocado and nuts and high calorie healthy foods. I do eat potatoes and rice. I just don't prefer them anymore. Give me quinoa.

Anyway, I need to eat a lot more and it's a lot of effort. I'm not hungry. I don't really know what food will trigger me or if I even get triggered anymore. I do have some anxiety about it so on some level I'm avoiding it.

Your post is bringing it home for me. I actually came on today hoping to find someone who is trying to stop losing. It's a head trip.

You are much farther into this than I am.

I am just glad you're here!

Edited January 19, 2014 by CBT

[CowgirlJane 14,259]

I am a little envious of this problem but not really......like I fight so hard to lose a pound it is easy to wish the weight would just fall off...Haha but a friend of mine has the same problem as you. He is very athletic but if he gets sick or stressed he gets SKINNY and it is no joke - a serious problem. He is 6foot2" and big framed and struggles to stay over 180.

What I am dying to know is how this happens to a formerly obese person. I have the obese metabolism (though others need to eat even less than me) and clearly you don't. Next time you see the endocrinologist can you ask how this happens? It contradicts everything I thought I knew about obesity.

I am working to build muscle mass to try to boost my burn rate. Problem I have is increasing burn always increases appetite too.

[CBT 450]

I am a little envious of this problem but not really......like I fight so hard to lose a pound it is easy to wish the weight would just fall off...Haha but a friend of mine has the same problem as you. He is very athletic but if he gets sick or stressed he gets SKINNY and it is no joke - a serious problem. He is 6foot2" and big framed and struggles to stay over 180. What I am dying to know is how this happens to a formerly obese person. I have the obese metabolism (though others need to eat even less than me) and clearly you don't. Next time you see the endocrinologist can you ask how this happens? It contradicts everything I thought I knew about obesity. I am working to build muscle mass to try to boost my burn rate. Problem I have is increasing burn always increases appetite too.

My BMR has always been high. It's not a result of WLS. He checks it to make sure it's not changing. I have always been muscular, as well. Now have Portion Control and I'm not hungry which results in mindful eating most if the time. So as I eat healthy, I eat less. I used to over eat and I ate whatever I wanted whenever I wanted it. food would call out to me from the cupboards. At times I really did have problem binge eating. I do not have that now. Gone. All gone. There's all kinds of stuff around here that I would've binged on preop. Now. Meh. VSG is hands down the tool I needed to help bring it all in line.

My body prefers to eat muscle over fat and that's been a challenge in my journey because I tend to like high intensity stuff. That's fun for me. (My endo would like it if I didn't sweat but he doesn't want me to stop doing what I love. He's not asked me to...yet. We've talked about it. ) Now my energy levels are high and match my BMR. Its insane. The people I dance with who've witnessed this transformation comment on it frequently.

He has talked about metabolic syndrome. That does not seem to apply to me. I definitely had more issues with estrogen.

My endo is covered by insurance, btw. He's part of the bariatric practice.

I'm happy to take questions to him. He's all about education.

[It's all new 453]

I just entered maintenance. I had a plastics consult and she told me to stop losing weight. I'm glad she did; still, I too have a high BMR closer to 3k. Measured regularly by the endocrinologist. I'm about 3 months overdue to meet with him :-/ About 7 pounds ago I thought I probably could stop losing. I just thought my body would figure it out. I keep losing. I think my sagging skin confuses my judgement. About food: if I want it, I eat it. I don't like the taste of fatty foods anymore. I too eat avocado and nuts and high calorie healthy foods. I do eat potatoes and rice. I just don't prefer them anymore. Give me quinoa. Anyway, I need to eat a lot more and it's a lot of effort. I'm not hungry. I don't really know what food will trigger me or if I even get triggered anymore. I do have some anxiety about it so on some level I'm avoiding it. Your post is bringing it home for me. I actually came on today hoping to find someone who is trying to stop losing. It's a head trip. You are much farther into this than I am. I am just glad you're here!

Yay! I have found another!! I've taken to eating all sorts of things - and plenty of carbs. You should see the huge glass of OJ I'm sitting here with at the moment. I don't have a carb monster anymore, as there isn't a food that is off limits or even a food to limit. I just try to meet my nutritional needs and caloric needs.

Don't let the saggy skin fool you!! My photos before my plastic surgery made me look as if I was still obese, yet I am only 5-10 lbs less now. 5 lbs when I am exercising heavily and my muscle mass is better, 10 when I have lost muscle. (Which happens quickly!). Point being, looking at the photos I looked obese, but obviously it was just skin.

I think I read you are planning plastics - it can be very hard to maintain weight after plastics as you can't exercise. (I expected the opposite problem, but with the high metabolism, and the fact that without exercising the appetite is even less, it was a problem). I lost a lot of muscle, and had to really fight to get the calories in. I didn't find that I needed to triple my calories, but I had a very hard time getting in even the same number of calories as usual.

[CBT 450]

The plastic surgeon really talked this point you're making through with me. She said my metabolism would TRIPLE in recovery! She also said if I didn't stop losing now, I'd lose too much during recovery even though I'm not working out because I can not eat enough to keep up with that metabolism.

So...I've been meal planning and making lists for DH so he can grab stuff from New Seasons (like Whole Foods) deli and meat counters to keep me fed. I do feel fortunate to have had some experience with surgery since I've had 2since VSG and I kinda know I really have to make it mental. I've got lots of crafts I can do while recovering but still....

I don't think I have a carb monster anymore either. Case in point, my kids ate cinnamon sugar pretzels today, which I used to love, and I got nothing. I did not want any. Mostly, I'm eating by the clock. I do get hungry but not enough to eat 1800-2000+ calories every day. I really want to eat for wellness.

[Skinnyminded 21]

I'm struggling to loose? Wtf