How Many Ounces of Food at Four Months Gastric Sleeve?

[pghmommy 2]

The nutritionist at my doctor's office is not particularly helpful. I was hoping that someone could give me some guidance as to how many ounces of food I should be eating at one time if I am four months out from a gastric sleeve? Does this amount change later on? If so, when? Thanks so much for any guidance!

[RobertaMSN 60]

My guidelines are 3 oz of Protein with 1 oz vegetable for lunch and dinner (as FluffyChix says below, by volume), and a green smoothie for Breakfast (but very little fruit), supplementing with up to two Protein Shakes to get enough protein. Dr. Duc C. Vuong on YouTube says when able, try to make the veg at either lunch or dinner a small salad cut into very small bites - haven't gotten to the point of trying it yet and imagine it's more than 1 oz..

He says to watch the protein amount - too much is just as bad as too little and it depends on how active we are and if we did anything extra such as go on a long, hard hike. He also cautions against relying on protein shakes and to pick high protein foods for meals.

I've been following his advice and taking very small bites, then chewing at least 20 times before swallowing - essentially making everything into a soft food. So far, so good. Apparently everything must be moist. He says patients "push their sleeve" one extra bite per meal, so to be mindful of stopping when satisfied and to question each bite "Do I need this?" There's debate as to whether or not it actually can stretch, but he says the body adjusts to tolerate more food and has seen patients back up to eating a large plate of food at a time and it's junk food - and regain the weight.

Bear in mind I'm new - only got mine on Dec. 2, 2019. But so far, so good. I've learned a great deal from Dr. Vuong - more than from my nutritionist in the program.

Edited December 26, 2019 by RobertaMSN

[FluffyChix 17,415]

Well are we talking by volume or by weight?

At 4 months I was on my forever diet. My RD would have been happy if I was still at 3/4cup VOLUME of food. But I was at 1 cup of food. But still losing well and my pouch just matured quicker. So it was ok. My Forever Diet specifies 1 cup of food per meal by volume. In that meal I need to shoot for 2-3oz of Protein (by weight = 1/4-1/2c protein by volume) + 1-2oz of veggies (by weight = 1/8-1/4c by volume) + a healthy fat + fruit/nuts/seeds/healthy low glycemic carb if room or more veggies.

If I eat raw veggies as in salad I have space for more. Veggies are kinda slidery on me. I can eat 1 1/2 to 2 cups of salad including about 2oz of protein in it, especially if I have cucumber, rbp, onions, radish, lettuce greens cuz they have lots of Water in them, plus the dressing makes them slippy.

I aim for 60-80g of protein per day. I am able to hit that pretty easy. And that was happening from 3-4mo out.

Edited December 26, 2019 by FluffyChix

[RobertaMSN 60]

Wow! You are doing incredibly well, FluffyChix! I'll definitely be following your advice.

[MarvelGirl25 2,168]

11 minutes ago, FluffyChix said:

Well are we talking by volume or by weight?

At 4 months I was on my forever diet. My RD would have been happy if I was still at 3/4cup VOLUME of food. But I was at 1 cup of food. But still losing well and my pouch just matured quicker. So it was ok. My Forever Diet specifies 1 cup of food per meal by volume. In that meal I need to shoot for 2-3oz of Protein + 1-2oz of veggies + a healthy fat + fruit/nuts/seeds/healthy low glycemic carb if room or more veggies.

If I eat raw veggies as in salad I have space for more. Veggies are kinda slidery on me. I can eat 1 1/2 to 2 cups of salad including about 2oz of Protein in it, especially if I have cucumber, rbp, onions, radish, lettuce greens cuz they have lots of Water in them, plus the dressing makes them slippy.

I aim for 60-80g of protein per day. I am able to hit that pretty easy. And that was happening from 3-4mo out.

Thank you! Im four months out too and this helps!

[pghmommy 2]

So, FluffyChix mentioned being able to fit in more salad. Should I assume that I should keep my total meal volume to one cup, even if I could fit in more healthy foods like a salad? Is this a permanent goal, or will it increase at six months, one year, etc.?

[pghmommy 2]

Another really stupid question -- what is the difference between measuring the food by volume and weight?

[FluffyChix 17,415]

4 minutes ago, pghmommy said:

So, FluffyChix mentioned being able to fit in more salad. Should I assume that I should keep my total meal volume to one cup, even if I could fit in more healthy foods like a salad? Is this a permanent goal, or will it increase at six months, one year, etc.?

That is the 64,000 question. Really the answer to this MUST or should come from 1.) Your Surgeon and 2.) Your RD. Frustrating right?

I personally try very hard not to chase a "FULL" feeling and let hunger be my guide. But that means I have to do a true "mindful meal" where I listen for the, "Meh, I'm no longer hungry" signal rather than the, "Meh, I'm full!" Cuz that feels differently post surgery. And you get into trouble when you chase "that full feeling." Cuz you really don't understand your "new full" yet.

So I ate to the doc's and RD's guidelines for WLM. I tried very hard not to exceed.

But now that I'm 22 months, I let hunger drive the bus. I don't need to feel full. But I don't want to go away hungry. And for me to have that happen:

1. I have to have no fluids with the solids. I drink broth before eating the solids in Soups and stews even. I do a 15/45 with fluids and try to Water load prior to a meal.

2. I still eat Protein forward (lean dense). 2-3oz per meal (1/2-3/4 cup by volume) weighed on a scale into a measuring cup or measuring rings.

3. I still eat al dente or raw veggies minimally processed (low fat). (1/8-1/4 cup by volume) weighed on a scale into a measuring cup or measuring rings.

3.5 I still add the equivalent of 1 tsp of healthy fat (or 1oz of avocado or 1 tbsp nut butter or 1/2oz seeds/nuts) to the meal.

4. I exceed my serving recomm with a slider add on to most dinners: 1oz avocado + 1oz grape tomatoes. Leaves me more satisfied/unhungry at the evening meal.

5. If eating a salad or raw veggies, will eat up to 1 1/2cups of salad/raw veggies.

But if I DO get a full signal, I stop and finish that meal at the next eating event. (ie mini meal)

[FluffyChix 17,415]

12 minutes ago, pghmommy said:

Another really stupid question -- what is the difference between measuring the food by volume and weight?

I do both. I use a food scale to measure by weight. I use grams or ounces usually. Grams are more accurate. There are 28.35g per ounce of food by weight. In that total weight, there is on average about 6-7g of pure Protein in that weight. That is the portion that adds up to the 60-80g daily protein goal.

I use either measuring cups or food rings to measure volume.

Volume is KING! You should not exceed your doc's/RD's volume prescription per meal for as long as possible. But you need to weigh protein (solid) to know how much protein you are actually getting... right? So I do both. But I'm an outlier.

[pghmommy 2]

How often do you eat each day? Snacks?

[FluffyChix 17,415]

Just now, pghmommy said:

How often do you eat each day? Snacks?

It depends on the day. Haha.

In the early days, I ate 4-6 times per day. Now days I do a complicated rotation. It's the way I maintain my weight.

This morning I was 129.4lbs--a Christmas Miracle I'm waiting to see if it sticks or not! If it does yay, if it doesn't I won't be devastated). But I'm at the bottom of a maintenance window I would not be sad to reduce by another 5 lbs to my BDG Goal = Barbie Dream Girl Goal. So it's business as usual for a Thursday for me =

Meal 1: B1 - 3 Protein lattes with 1oz of Premier Protein + 7 drops vitacost liquid Stevia + Decaff + ground cinnamon
1 cup tea (green decaff tea + Earl Grey decaff tea + 1 shot of unfiltered ACV + 1 lemon wedge + cayenne + ground cinnamon)

Meal 2 (optional): B2 - I will either eat around 10-11 or I will skip if not hungry.

Meal 3: L-Big Ass salad (1 1/2-2c of salad + 2-3oz dense lean protein + 2-3tbsp Zero Cal Dressing + 1 serving healthy fat (I will eat this until full. Sometimes it's the whole thing and sometimes I finish the balance as my afternoon snack) OR

Turkey cheese Rollup with raw greens and veggies OR

Green Soup OR

Green Smoothie with Fiber OR

Can of Sardines and Raw Veggies

Meal 4 (optional and regulated by hunger): AS-Either leftovers from lunch OR
cup of Herb OX no sodium broth + baby greens + mushrooms OR
1 hardboiled egg OR
3-5 oz of raw veggies + 1/4c fat free Greek Yogurt Dip (Tzaziki, Ranch, Onion, Asian)

Meal 5: D-3oz protein + 1-2oz veg + 1oz avo/1oz tom + 1 serving healthy fat or extra cheese

Meal 6 (optional and regulated by hunger): BS-usually a decaff + 1oz Premier Protein OR

1-2oz underripe GS Apple or pear + 1tbsp nut butter OR 14g walnuts or almonds OR

1 square 90% Lindt chocolate + 14g walnuts or almonds

[Brent701 438]

Fluffy it is amazing you were ever morbidly obese. Your regimen is like a machine. Is it the fear of going back that motivates you to keep it off?

[AJ Tylo 1,399]

I have a personal Nutritionist and from Day one she has said - Do not worry about volume or weight our goal is to keep you balanced and low calories. I to this day have never weighed a thing or measured a thing.

I eat Protein and vegetables and fruit till i am full. Which is about the amount of a baby food jar. For some reason i was lucky - I am never hungry and go days without eating anything. Enjoy eating i am told but eat right! I keep my calories below 600 a day and just now have tried to get up to 750 - That is a ton of salad!

As for fluffy i think she is a bot! she has to much knowledge to be a human and is correct!

[FluffyChix 17,415]

52 minutes ago, Brent701 said:

Fluffy it is amazing you were ever morbidly obese. Your regimen is like a machine. Is it the fear of going back that motivates you to keep it off?

Haha. So look. People are different. Right? And the mistake most of us make is assuming that other people see the world through the same filter or lens as our own. Right? And when we observe someone we think in terms of the filter and value as it relates to our belief system. So you look at the way I interact with food and nutrition from YOUR perspective and it just feels like a craptastic amount of work, effort, and feels like it's living in penury.

I on the other hand have 20+ years of knowledge about this stuff and most of it is autopilot. I was MO for a variety of reasons including making poor food choices/behaviors. But also because of medical and genetic reasons...you know, like most of us. For me, I don't feel like I'm skimping on a single day. I adore my food! Both the good choices and the bad! I'm not 100% perfect on any given day. But I do try. So it's not onerous. It's a pleasure.

And because this works for me, there is comfort in the knowing. And I'm not the only one who does this. Over almost 2 1/2 years in this world, I noticed that THE most successful vets - without exception - are the ones who do not try to wing it. And who do not buy into the dual myths of restriction and malabsorption. They apply their knowledge. The follow a format. And the know how much they weigh each day, what they consumed, and how much exercise they did.

I decided long ago, that if I was gonna cut out 80% of my tum and reroute feet of intestine, I was in it to win it. I didn't want the scenic tour- been there done that. I wanted to TCB as quickly as humanly and safely possible.

And I did. Now I can spare a few fun times each week that keep me excited and looking forward to M-Thurs on plan TCB living doing the things that will promote DEEP health in the long run!

I'm so deprived. In Texas the day after Christmas is usually Mexican food. So I decided to make a taco with leftover 90/10 hamburger that I drain the fat off of cuz if I eat too much fat at a meal I feel miserable. I'm in the process of eating this right now. It's about 2 cups of salady food and about 2oz of Protein in it. I will show you afters. I will have that at my next meal--probably afternoon snack. Now doesn't that look like an, "Oh, poor me, I'm so oppressed meal?" Who WOULDN't want to eat this way given half a choice?

Ok, done for this meal. Here are the leftovers for AS:

 

And here's how the whole thing shakes out in MFP. I save it as a Meal, then next time I eat it, I will just go pull it up and see what was in it and replicate it. Then I just select that meal and the size that I eat and enter into a meal slot. Takes about 2 seconds to do once it's saved.

So my lunch was about 200 cals and I go 18g of protein in with less than 10g of whole carb. Not bad, could be better cuz I do aim for 1g of protein per 10 calories.

Edited December 26, 2019 by FluffyChix

[Brent701 438]

I would rather be fat/current state than ever have to deal with logging 13 ingredients for a wrap into MFP.

Edit: What you have accomplished is amazing but there is a level of obsession most people are not ready to commit to.

Edited December 26, 2019 by Brent701