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The Maintenance Thread



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3 hours ago, KT1981 said:

Hi friends! I am about to start maintaining. I got some advice that I felt was a bit conflicting from the PA (she is new to the practice) at my appointment today. Here's the scenario:

They don't want me to lose anymore, but would be accepting of up to another 10 pound loss, preferably only 5 pounds. (At this point, I suspect most of my concern areas will need to be address by PS anyway, and not by weight loss. Starting a conversation with a plastic surgeon is on my to-do list yet this year, although I won't pursue a surgery date until I have stabilized, of course.)

I agreed to this minimized loss at the appointment (I wanted to lose 15 more), but here's my question- I was told to stick with the calorie intake I'm currently at, even though I made it clear that I'm still actively losing at this intake level (~1200 calories). I upped it about 2 weeks ago and the loss hasn't slowed at all. She doesn't want to see me again for 6 months unless I lose more than 10 pounds before that. Ya'll... unless I very rapidly stabilize at this caloric intake, I'm probably going to lose these 10 pounds before Christmas, based on my current loss rate. In 6 months, I could very well lose 20 or more if I don't find a new caloric intake. I felt a refusal to work with me on transitioning to maintenance calories before 18 months is up, but at the same time, I was pretty explicitly told that I really should stay where I am weight-wise.

I specifically asked if I should incrementally increase calories or anything like that if the loss doesn't slow down, and was told no... just stay where I am until we meet again in 6 months, but also, don't lose any more weight unless you really feel you must, then absolutely no more than 10 pounds. This just feels odd to me, knowing that transitioning to maintenance can take some time, and I'm actively losing where I am now.

Am I missing something? I realize it's totally possible for me to very suddenly stabilize, but that doesn't appear to be the case for me at the moment.

What were your conversations like with your team when you began transitioning to maintenance? I really feel that if I don't start experimenting with slowing the loss now, that I run the risk of losing too much and being unhappy with how I look.

Fantastic work! Congratulations on goal and moving into maintenance.

Conflicting information is frustrating. It maybe because this person is new. Can you call for clarification on maintenance phase food instructions? I agree with @FluffyChix. and @ms.sss I wouldn’t worry about your next appointment . At 5'5" Healthy BMI is 150 to 112 lbs - If you are getting close to 112lbs (underweight) call your team.

My office gave me the one size fits all maintaining plan. I hit goal at my 6th month appointment. my surgeon told me if I lost ten pounds, I would be my ideal weight. The nurse said” I would look less skeletal if I gained ten pounds” Obviously, my gold standard team was not helpful with my transition into maintenance.

Find a weight you feel healthy at to maintain. You got this.

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I have increased my calories and slowed my weight loss. I am now at 127 fairly consistently at 5 ft 2.5 in. I know I could still lose more and be in the normal BMI range however I have muscular legs and have saggy skin with wrinkle above my knees and baggy arms etc. so I don't want to lose anymore. I would be happy where I am at but ideally would like to be 5-10 pounds heavier to fill in a bit. I am thinking I should try to maintain this 127 for now assuming I will regain the bounce weight at some point and still be in a good range.

However, over the last few weeks I lost 1-2 pounds and I guess my fat has shifted or maybe I gained a little muscle and lost more pounds of fat. My butt is saggy like an old lady and flat so I don't have much padding. Now my bum gets sore sitting too long even on the couch. I also have to wear shoes or slippers on my wood floors since my heels feel sore. I have had to sleep with a pillow between my knees for a few months now since my knees are bony. Maybe I am just overly sensitive?

So my question to those that are at normal BMI did you go through this? Did you just get used to it or did your weight or body fat redistribute? I am already forcing myself to get in 1400 calories to maintain but still lost a few pounds over the past month.

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On 10/14/2019 at 12:49 PM, Sheribear68 said:

*sigh*

Even when I plan out how to get in extra Protein, I’m STILL struggling to get in 800 cal

The “before” is what I originally planned to eat today.
Even with adding in 1/2 cup cottage cheese (which will be the limit on what my sleeve will be able to hold alongside a p3 pack) it’s still not much more.

Least the Protein is good.

image-0.0029802322387695312.jpg

image-0.0020265579223632812.jpg

I wanted to slow down my weight loss back in August so I went from around 700 to 1000 calories and stalled for 2 weeks then went back to dropping a few pounds a week. It took purposely eating high calorie Peanut Butter, adding olive oil to food etc to get to 1200 and that slowed things down but I was still losing. Now i am at 1400 and seem to have slowed to only 2 lbs the past month but i can see a big difference losing fat from my lower back and waist. I think maybe the extra calories actually allowed my body to gain muscle or stop losing some muscle and that i actually lost more than 2 pounds of fat.

So even though its been a few months of trying to maintain but still dropping if i see the scaled (I weight daily) move up 1-2 pounds i still get a little fear even though I am purposely trying to maintain. It is such a mental game. I also was afraid of carbs but the NUT said for me to go to a "normal" ratio of 40% carbs, 30% fat, 30% protein. So that at 1200 calories I am still above 90 grams of protein. I usually end up higher on the fats (good fats) and hardly even get past 35% carbs. It was hard to mentally switch. I purposely chose carb foods like boring triscuts that are not desirable to me so i wouldn't mentally start to crave carbs like breads or Cookies etc.

Nobody is kidding when they say it is a process and is not just physical.

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21 minutes ago, 2Bsmaller18 said:

However, over the last few weeks I lost 1-2 pounds and I guess my fat has shifted or maybe I gained a little muscle and lost more pounds of fat. My butt is saggy like an old lady and flat so I don't have much padding. Now my bum gets sore sitting too long even on the couch. I also have to wear shoes or slippers on my wood floors since my heels feel sore. I have had to sleep with a pillow between my knees for a few months now since my knees are bony. Maybe I am just overly sensitive?

So my question to those that are at normal BMI did you go through this? Did you just get used to it or did your weight or body fat redistribute? I am already forcing myself to get in 1400 calories to maintain but still lost a few pounds over the past month. 

Saggy butt - CHECK!

Sore butt when sitting on hard surfaces - CHECK!

Spine pain/bone rubbing when leaning back on a bench - CHECK!

Need for slippers/shoes on wood and tile floors - CHECK!

Knocking knees at night - CHECK!

I got used to it. I'll take all of the above over being obese any day.

With that said, I do notice that my body "material" is still changing/shifting (despite actually weighing less now than when I first started maintenance): my face (cheeks and eye sockets) have filled in some and my loose skin has either tightened up (comparatively) or something is shifting around under it to make it look that way. I suspect its the increase in carbs in my diet that is contributing to this "filling out" (the one time when bloat is good! lol).

...and on a related note, my hair is growing back in!! I am now the proud owner of a whole bunch of ridiculous chicken hairs sprouting all over my head (the same ones I coveted from @sillykitty way back when I thought the shedding would never stop)

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1 hour ago, 2Bsmaller18 said:

I have increased my calories and slowed my weight loss. I am now at 127 fairly consistently at 5 ft 2.5 in. I know I could still lose more and be in the normal BMI range however I have muscular legs and have saggy skin with wrinkle above my knees and baggy arms etc. so I don't want to lose anymore. I would be happy where I am at but ideally would like to be 5-10 pounds heavier to fill in a bit. I am thinking I should try to maintain this 127 for now assuming I will regain the bounce weight at some point and still be in a good range.

However, over the last few weeks I lost 1-2 pounds and I guess my fat has shifted or maybe I gained a little muscle and lost more pounds of fat. My butt is saggy like an old lady and flat so I don't have much padding. Now my bum gets sore sitting too long even on the couch. I also have to wear shoes or slippers on my wood floors since my heels feel sore. I have had to sleep with a pillow between my knees for a few months now since my knees are bony. Maybe I am just overly sensitive?

So my question to those that are at normal BMI did you go through this? Did you just get used to it or did your weight or body fat redistribute? I am already forcing myself to get in 1400 calories to maintain but still lost a few pounds over the past month.

I still have boney butt syndrome. Hard chairs in restaurant’s kill me. I still sleep with a pillow between my knees.

Where weight stops is hard to predict. (Starting weight and many other factors). I would have been happy at overweight BMI. I was expecting 60% weight loss with the sleeve. My weight stopped at a BMI of 20.

I lost muscle with rapid weight loss. Building muscle became easier with increased calories. I weigh ten pounds more than my lowest weight. My clothing fits better and I filled out some loose skin with weightlifting.

Did you ever think eating would be a chore after goal? It gets better over time. You can gain if you choose. It may not happen until you can consume more calories

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43 minutes ago, ms.sss said:

Saggy butt - CHECK!

Sore butt when sitting on hard surfaces - CHECK!

Spine pain/bone rubbing when leaning back on a bench - CHECK!

Need for slippers/shoes on wood and tile floors - CHECK!

Knocking knees at night - CHECK!

I got used to it. I'll take all of the above over being obese any day.

Ditto. :)

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So I’ve been thinking about all of this and I’m wondering where my body will choose to settle in.
When I set my GW at 155, it was primarily bc for my height that put me just at the upper edge of normal BMI.
I also thought that there was no way in hell I would actually get to this weight bc I knew it would mean losing >80-90% of my excess fat and since I was choosing sleeve, I knew that was going to be extremely difficult.

Well here I am at this weight and I have no plans to get on the scale this week bc I’m trying not to focus on the number as much as my body.
Besides, if I have any kind of gain I don’t want to freak out over it. My plan now is to focus on increasing carbs and calories and if I see a gain it will be counterproductive.

If I’m very honest with myself (and I MUST be for this to work long-term) I’m hoping for and expecting another 5-10 pound weight loss over the next 2-3 months bc if I actually gain or don’t continue to lose weight at <1000 calories daily then I’m screwed.

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3 hours ago, Sheribear68 said:

So I’ve been thinking about all of this and I’m wondering where my body will choose to settle in.
When I set my GW at 155, it was primarily bc for my height that put me just at the upper edge of normal BMI.
I also thought that there was no way in hell I would actually get to this weight bc I knew it would mean losing >80-90% of my excess fat and since I was choosing sleeve, I knew that was going to be extremely difficult.

Well here I am at this weight and I have no plans to get on the scale this week bc I’m trying not to focus on the number as much as my body.
Besides, if I have any kind of gain I don’t want to freak out over it. My plan now is to focus on increasing carbs and calories and if I see a gain it will be counterproductive.

If I’m very honest with myself (and I MUST be for this to work long-term) I’m hoping for and expecting another 5-10 pound weight loss over the next 2-3 months bc if I actually gain or don’t continue to lose weight at <1000 calories daily then I’m screwed.

I understand your thinking that if you gain now or stop losing at 1000 calories you will be stuck at that level forever but remember at the beginning only eating 400 calories and based on the calories we were burning we should have lost 5 pounds a week. Most of us didn't. From what I have read I think your body goes into a starvation mode and while you lose weight your body is efficient at trying to find a balance.

You may gain a few pounds initially when you increase calories and carbs or be surprised and lose more than you thought. I have read that most people long term maintain at well over 1000 calories a day. You are so active at work and with exercise i wouldn't be surprised if in 6-12 months you are maintaining at 1500 per day. Doesn't that seem like so much food at this point? It's so crazy to think I could easily eat 3000 calories easily on a random Saturday a year ago. Now that thought makes me nauseated.

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On 10/17/2019 at 12:12 PM, FluffyChix said:

OMG. I know, right? LOL. But every time I start to deep dive into "mental" about it, I actually think of you and also think of @proud grammy and @BigViffer and some of the other vets here who have or had regains that they just pretty concisely "dealt with"

Just to clarify - I do not count my weight as "regain". I bottomed out at 199 16 months after surgery. That is also when I switched from exercise to weight training. I started gaining for the next 13 months at a healthy pace until I hit about 225. For the past 27 months I have fluctuated up and down from the 225 mark, but never above 230 nor below 220.

I view my gain is the natural rebound before going into maintenance. My original goal weight was 220, so I'm happy as a lark at 225. I am sure that if I ever get the skin removal done, I will lose that pesky 5 lbs.

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1 minute ago, BigViffer said:

Just to clarify - I do not count my weight as "regain". I bottomed out at 199 16 months after surgery. That is also when I switched from exercise to weight training. I started gaining for the next 13 months at a healthy pace until I hit about 225. For the past 27 months I have fluctuated up and down from the 225 mark, but never above 230 nor below 220.

I view my gain is the natural rebound before going into maintenance. My original goal weight was 220, so I'm happy as a lark at 225. I am sure that if I ever get the skin removal done, I will lose that pesky 5 lbs.

Thanks for clarifying! I was actually mis-remembering then. I thought you had had a very small regain and that you'd attacked it and taken it back off. But you are sooo right, body building gain is way different than a "regain" scenario. One is muscle, the other is more likely associated with fat.

Congrats!!! And thanks for continuing to inspire me!

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On 10/17/2019 at 1:44 PM, FluffyChix said:

I'd follow her plan. She wants to know if your body can "naturally" slow down at the 1200cals per day. At 5'5" you are only at the very beginning end of normal. You're still losing at that rate cuz you have extra fat to lose. Your body should theoretically start slowing down when it's nearing a set point. For a lot of us that appears to be somewhere between 19-21% fat. The loss should crawl to a stall.

Add too many cals back, then you are artificially maintaining at a weight your body doesn't really want to support.

If you are in the normal BMI category (not an athlete, not power lifting, not endurance training, not overly muscular, aren't "big boned", etc...you know, just average, then this chart can apply to you.)

This makes so much sense. I know that I am still at 27+% body fat, so, while within health range, I definitely have room to lose/transition to muscle. It also makes sense to let my body decide when to stop losing. That was kind of my plan all along, and I am assuming it'll be close to 130 (not really sure why I think that, though!). I do have a fear that I will not like my body in another 20 pounds, though. I'm mostly happy with how I look now, with the exception of my stomach. Another 15+ pounds may change that, but we can cross that bridge if we get there!

The odd part is that my office doesn't really go by the BMI chart... they go by the ideal weight. For me, that's 132, so they don't want me below that, even though I'd still be WELL within a normal BMI range. Personally, I wanted to get to 130 because I think that gives me room to gain over the next 20+ years (a natural process of aging) and still be in a normal BMI. I even explained that and was basically told, "Nope. Only lost 10 more pounds, if you absolutely feel you must, because then you'll be at your 'ideal weight' and we don't want to go lower than that". I guess that's the part that's confusing to me- they are adamant that 135 is the absolute lowest, but when I look at a BMI chart, I have plenty of wiggle room. I may reach out to another PA that I've worked with before to get more clarification on that piece. But, for now, I'll let my body do it's thing. Thank you for your insight!

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On 10/17/2019 at 1:04 PM, LynnV1964 said:

That is odd! Not sure how you are expected to maintain if you eat the same calories that make you lose... I don’t think it could hurt to add 100 cal a day for a week or two at a time to see where you stop losing. That’s how I found my maintenance level (1600-1900....so far. Maybe I could do 2000?). Then again I’m not your nutritionist or dr. Are there other nutritionist at the surgeons office you could call and talk to? Or could you talk directly to the surgeon or a PA to get their thoughts on this?

I find it SO odd. I spoke with a new PA, but I may reach out to one of the PA's I've worked with throughout most of the process for some more clarification on things. In the meantime, I'll let my body keep losing.

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On 10/17/2019 at 5:37 PM, Healthy_life2 said:

Fantastic work! Congratulations on goal and moving into maintenance.

Conflicting information is frustrating. It maybe because this person is new. Can you call for clarification on maintenance phase food instructions? I agree with @FluffyChix. and @ms.sss I wouldn’t worry about your next appointment . At 5'5" Healthy BMI is 150 to 112 lbs - If you are getting close to 112lbs (underweight) call your team.

My office gave me the one size fits all maintaining plan. I hit goal at my 6th month appointment. my surgeon told me if I lost ten pounds, I would be my ideal weight. The nurse said” I would look less skeletal if I gained ten pounds” Obviously, my gold standard team was not helpful with my transition into maintenance.

Find a weight you feel healthy at to maintain. You got this.

Thank you! Once I get closer to my personal goal I will reach out to speak with one of the PA's I've been working with (this one was new) to gain more clarification. For now, I will try to keep actively losing and just pay attention to what that looks like calorie-wise.

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On 10/14/2019 at 1:23 PM, ms.sss said:

Back from vacay with Mr. a few days ago

So all the unnecessary worrying about food and carbs pre-trip was just that: unnecessary.

I let myself eat whatever, there was nothing off limits. Though I did make sure not to eat to a stuffed feeling (failed a couple times, though I admit...damn you eating and drinking at same time!). For the most part, I figured if I couldn't eat something cuz I was already satisfied, I could always try it another time. No biggie.

I had Pasta, bread and rice for the first time since surgery, all of which I tolerated well. I found that while I still enjoy Pasta (they must put crack or something in the pasta over there, cuz I just couldn't get enough), I don't really care for bread nor rice anymore. Which is surprising because bread and rice were every-meal-staples for me pre-WLS.

Drank wine like Water. Developed a loving relationship with amaretto. I suspect 80% of the carbs I consumed while away came from liquor.

The morning we left, I weighed 115.6 with 16.5% body fat.

Despite all the food and drink (and the fact that I did not go to the hotel gym once, nor go for a single run the entire time), the morning after the day we came back (2 weeks, 3 days later), I was only up to 119.9 with 17.7% body fat. I was totally prepared to see a 10 lb increase! Now I sort of wish that I tracked my food (I didn't use MFP at all, as I was giving myself a vacay from that as well) because I really would like to know what my average daily calorie/macro intake was. I would guess that it was probably in the 3000-3500 range, though (some days probably double that...specifically the days when I had TWO double scoop gelatos instead of one)

Now for the good part:

I wanted to get back to my day-before-vacay- weight, so I (easily!) went back to my running routine, and ate lower-carb, and kept my cals to about 1000-1300. I track everything I put in my mouth, and weigh myself every day at the same time. And this morning, I clocked in at 115.2 with 16.3% body fat. *drops mic*.

Moral of (my) story is that for those in maintenance, the chances to indulge will come along, take it and enjoy within reason (life is short!), and trust yourself that you will be able to work off any gains, so long as you put in the effort. I am now officially confident that I will be a successful long-term maintainer!

Life is Good.

Welcome back!

This has been my exact same experience. I am incredibly grateful because traveling and enjoying all aspects of culture, and most especially food culture is hugely important to me.

I wouldn't rule out bread. Bread in Italy just sucks for some reason, unless it is pizza or focaccia!

Where in Italy did you visit?

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