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Confused about calories in Stage 4



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I am in the smooth food stage, and I track everything I eat on Fitness Pal. I am confused and frankly a little concerned about calories moving forward (or even now, really). My nutritionist specifically said not to worry about calories, to concentrate on Fluid and Protein goals, and learning to stop eating when full. She also wants me to concentrate on mindfully planning and eating 3 meals (obviously small) and 2 Snacks per day and not eat outside of those parameters. She said most peoples calories fall between 700 and 1000 per day. This all makes sense to me.

What I am concerned about is I have read several different places on this site where people are eating 300 calories per day! I can't imagine how they get their protein in! Even at 500 calories it seems like you can't be getting any variety. Even on the soft food stage I have hit 500 calories. Today I had 3 TBS egg whites and 1 tbs Ricotta omelet; snack of a Protein Shake made with Water (90k); lunch of 1/4 cup cottage cheese with 1/2 banana; snack of cup of Bone Broth and 1/4 c. sugar free Jello pudding made with Fairlife Milk; dinner of 1/2 packet of cream of wheat with 2 tbs. Ricotta, 2 tbs. sugar free apple sauce, 1/4 c. refried Beans. My calories were just over 500, my protein was 60. I am comfortably full. But my concern is that I am eating too much! And once I go to "normal" foods, I am afraid I won't be able to stick to such a low amount.

What do people eat per day in calories (including protein shakes) in the rapid weight loss months?

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you are fine. I just checked and I was eating 500-600 at that point. Starting at six weeks out, I was at 600-800 and stayed in that range for several months. (I didn't consistently go over 1000 until I was almost a year out, so your dietitian's range seems a bit high). 300 seems really low, though - except for maybe the first few days after surgery.

that said, I didn't worry about calories that early out. It took effort to get all my Protein in - so no way was I taking in too many calories. I don't think I seriously started counting calories until I was a few months out.

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7 hours ago, catwoman7 said:

you are fine. I just checked and I was eating 500-600 at that point. Starting at six weeks out, I was at 600-800 and stayed in that range for several months. (I didn't consistently go over 1000 until I was almost a year out, so your dietitian's range seems a bit high). 300 seems really low, though - except for maybe the first few days after surgery.

that said, I didn't worry about calories that early out. It took effort to get all my Protein in - so no way was I taking in too many calories. I don't think I seriously started counting calories until I was a few months out.

Thank you so much for your thoughtful answer. I overthink things sometimes!

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4 hours ago, MsMocie said:

You are fine. I eat 300 because I can't handle food. So does most of my low on low-calorie friends. Would def eat more if I could just swallow it. It is not safe over time, so don't be bothered by it.

I suffer malnutrition as a consequense.

I'm so sorry for your problems swallowing. Thank you for your response.

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5 hours ago, MsMocie said:

You are fine. I eat 300 because I can't handle food. So does most of my low on low-calorie friends. Would def eat more if I could just swallow it. It is not safe over time, so don't be bothered by it.

I suffer malnutrition as a consequense.

I'm sorry you struggle. Just out of curiosity, have you had pre-albumin levels drawn, albumin levels? How do you know you suffer malnutrition?

OP: Like @catwoman7, I was around 500 cals at that phase. I would honestly focus on Protein rather than the more carby things. And btw, embrace boring. You had WLS for a reason. I'm assuming it is to help you lose weight? Perhaps to help you have a chance to change the relationships with food that qualified you to have this type of extreme surgical intervention for obesity??? Most of us did...

Edited by FluffyChix

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10 hours ago, lisafrommassachusetts said:

My nutritionist specifically said not to worry about calories, to concentrate on Fluid and Protein goals, and learning to stop eating when full. She also wants me to concentrate on mindfully planning and eating 3 meals (obviously small) and 2 Snacks per day and not eat outside of those parameters. She said most peoples calories fall between 700 and 1000 per day. This all makes sense to me.

You are exactly correct Stay hydrated and Stay Protein. I ran about a average of 800 calories a day but everyone is a little different.

The key above is the statement LEARN to control your eating in terms of quality and quantity! It gets alot easier as you plow thru the journey

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You are fine. Honestly, at this stage you shouldn't worry so much about Calories. Drink your Water, eat your Protein, and if you have a little room and can tolerate, get a few veggies in. Control your quantity and quality of your food. Eat small meals/snacks every 2 1/2 - 3 hours or so (or whatever your doctor/nutritionist advises). Take your time eating (something I still struggle with nearly 6 months out). Don't snack between meals.

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Follow your plan, Protein first, Water and then the rest will follow. My nut also told me to not worry about calories, as long as you get your protein and water in you will be fine! Don't worry about what anyone else is doing or not doing. You've got this!

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2 hours ago, FluffyChix said:

I'm sorry you struggle. Just out of curiosity, have you had pre-albumin levels drawn, albumin levels? How do you know you suffer malnutrition?

OP: Like @catwoman7, I was around 500 cals at that phase. I would honestly focus on Protein rather than the more carby things. And btw, embrace boring. You had WLS for a reason. I'm assuming it is to help you lose weight? Perhaps to help you have a chance to change the relationships with food that qualified you to have this type of extreme surgical intervention for obesity??? Most of us did...

Thank you. As you can see from my eating yesterday, I have boring down! Lol. I agree that this is a great time to learn to have a different relationship with food.

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1 hour ago, Lynda486 said:

Follow your plan, Protein first, Water and then the rest will follow. My nut also told me to not worry about calories, as long as you get your Protein and Water in you will be fine! Don't worry about what anyone else is doing or not doing. You've got this!

Thank you!

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20 minutes ago, lisafrommassachusetts said:

Thank you. As you can see from my eating yesterday, I have boring down! Lol. I agree that this is a great time to learn to have a different relationship with food.

Haha. Actually for me personally, exciting high reward foods would be the faster carb choices in your day of eating that have lower protein: refried Beans and cheese and the hot Cereal. :) I'd be hungry in 30 minutes, even at your phase, cuz it hits my blood stream very quickly and causes an insulin spike and rise in blood sugar, then a crash 30 minutes to 2 hours later. I did better keeping it to super boring, high Protein choices that kept my insulin and blood sugar as flat as possible.

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2 hours ago, FluffyChix said:

Haha. Actually for me personally, exciting high reward foods would be the faster carb choices in your day of eating that have lower protein: refried Beans and cheese and the hot Cereal. :) I'd be hungry in 30 minutes, even at your phase, cuz it hits my blood stream very quickly and causes an insulin spike and rise in blood sugar, then a crash 30 minutes to 2 hours later. I did better keeping it to super boring, high Protein choices that kept my insulin and blood sugar as flat as possible.

Oh, I did not realize that! I am eating what they gave me as choices; Refried Beans, Ricotta cheese and Cream of Wheat were on the very limited choices. And low-fat Cottage cheese. Egg whites are the only really high Protein, I think. sugar free apple sauce and bananas were the only fruits, and there are no vegetables until I am 20 days post surgery. I am aware that the Cream of Wheat has no protein; I added a little ricotta to give it some protein. Truthfully ricotta and cream of wheat have no taste without at least a little salt, which I have been mostly avoiding. I have not really noticed any hunger, but I will be more mindful of this! I can just as easily stick to egg whites and cottage cheese. Also, I did make some sugar free pudding (on the list) but used Fairlife Milk so it has some protein. Is Fairlife milk ok, if you know?

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5 hours ago, AJ Tylo said:

You are exactly correct Stay hydrated and Stay Protein. I ran about a average of 800 calories a day but everyone is a little different.

The key above is the statement LEARN to control your eating in terms of quality and quantity! It gets alot easier as you plow thru the journey

Thanks! I appreciate the voice of experience.

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5 hours ago, momof3_angels said:

You are fine. Honestly, at this stage you shouldn't worry so much about Calories. Drink your Water, eat your Protein, and if you have a little room and can tolerate, get a few veggies in. Control your quantity and quality of your food. Eat small meals/snacks every 2 1/2 - 3 hours or so (or whatever your doctor/nutritionist advises). Take your time eating (something I still struggle with nearly 6 months out). Don't snack between meals.

Thank you! What a great weight loss you have had in 6 months. I am missing vegetables! I really think I need to go back to work so I am not sitting around thinking about this all day. :) I go back this coming Monday, and I am sure I will regret those words...

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20 minutes ago, lisafrommassachusetts said:

Thank you! What a great weight loss you have had in 6 months. I am missing vegetables! I really think I need to go back to work so I am not sitting around thinking about this all day. :) I go back this coming Monday, and I am sure I will regret those words...

LOL... going back to work is a blessing and a curse! Distraction is good though, as long as you have the energy to get through the day. And veggies are great! Just start slowly with cooked veggies. After 4 weeks I was given the ho ahead to eat anything (healthy) my stomach could tolerate. Start with soft veggies then progress to firmer ones once your doc gives the all clear. It is funny, I could eat broccoli and celery before I could tolerate lettuce. I would have thought the opposite. Have only been eating salads for a few weeks now.

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