At what point do you really worry about losing too much too fast?

[Evenkeel 5]

I'm a few days shy of five months post-op and down 87 pounds. I'm 18 pounds from the top end of a "normal" BMI at 150. I'm still losing at a rate of 2-4 pounds a week, so if I keep following my current average trend I'll be there in six weeks. I met with a nutritionist who is quite alarmed at the amount of the loss and the potential for my food tolerance issues to not only keep it going but potentially cause damage to my heart muscle if it hasn't all ready. She readily admitted that she doesn't have much experience with gastric bypass patients but still thought it seems abnormal. She also said that 130 pounds would be the point at which action would absolutely need to be taken if I keep going at the rate I'm going but she'd really rather see something hapoen sooner than later.

So, any thoughts? Is she being overly cautious? Should I be proactive or would I be wasting my time?

[James Marusek 5,244]

The three most important elements after RNY gastric bypass surgery are to meet your daily Protein, Fluid and Vitamin requirements. food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight.

Weight loss is achieved after surgery through meal volume control. You begin at 2 ounces (1/4 cup) per meal and gradually over the next year and a half increase the volume to 1 cup per meal. With this minuscule amount of food, it is next to impossible to meet your Protein daily requirements by food alone, so therefore you need to rely on supplements such as Protein shakes.

After my RNY surgery, my weight loss tapered off and came to a natural plateau at 7 months. At your stage loosing 2-4 pounds per week, in my opinion doesn't seem too drastic. Right after my surgery, I was losing 2 pounds a day at the beginning. I am 5 foot 6 inches tall like yourself but I am a male. I went down to 143 at my lowest weight. In your case you might actual get down to 130 pounds before leveling off.

So make sure that you are getting in your required protein, fluids, Vitamins, 30 minutes of walking each day or equivalent, and the specified meal volume and try not to worry too much.

[Evenkeel 5]

That's part of my problem. Due to food intolerances and other as-yet-undiagnosed gut issues not related to surgery it's nearly impossible to get 70 grams of Protein or anywhere near a decent number of calories a day. I also can't tolerate shakes of any kind. My digestive system, especially my stomach and first part of my intestines, just doesn't cooperate. Exercise is therefore an issue because I burn calories I can ill afford to lose. I do it, but then I lose even more weight that week. Vitamins are fine and I try my hardest to get my fluids but pushing those then interferes with eating. Getting to somewhere between 130 and 150 and leveling off would be perfect. Plateauing at 7 months would still be okay for me. Thanks for your reply!

[BrookeTiffani 54]

I sure hope things level out for you. The nutritionist seems worried, but have you spoken to your surgeon? He/she may know more about it. Just a thought. Have you had any stalls at all? I will be 1 month out tomorrow and have hit a stall at 2 weeks out.

[Evenkeel 5]

One stall at three weeks for one week. I should call my surgeon but through all of my issues all he's said is "You're doing great! I think you're going to be one of the lucky ones to lose all of your excess weight." and shrug his shoulders otherwise. Let's say I'm not optimistic he'll be helpful.