1 month post op. Shocked by nutritionist’s recommendations. Anyone else?

[ThisMomOf5 9]

At my 1 month post op, I was told to eat 1100-1200 calories including 110 grams of Protein, 60g carbs, 45g of fat a day and no foods are off limits as long as I hit those targets. Pre-op I wasn’t a huge eater and these numbers are only a few hundred calories off from what I was eating. I gained weight as a result of insulin resistance and other health issues. I was also told that my 15lbs lost at 1 month was good but slower than most. At that point I had been stalled for a week.

Anyone else given similar recommendations? Did you lose as planned? I’m trying not to second guess my team but from what I’m reading, this seems like more than most people are told and doubt is creeping in. I’ve learned over the years that medical professionals are people too who make mistakes and nutritional advice seems to change (low fat vs no low fat, artificial sugars vs no artificial sugars etc) so I’m trying to see if other people’s experiences support this advice. After all, ultimately my health is my responsibility. Thanks in advance for any feedback you can offer!

Edited March 27, 2021 by ThisMomOf5

[catwoman7 11,210]

there seem to be a few surgeons who are recommending that calorie level these days as this isn't the first time on here that I've seen it - but it's high compared to most programs (however, most tell patients to just focus on Protein and fluids the first few weeks and don't worry about calories. I only knew what my calorie intake average was because I was tracking from the get-go).

The kind of odd thing is that they told you nothing is off limits. That's true once you're in maintenance, or at minimum, a few months out - but early on we were told to stick to very nutrient-dense food (which would not include things like Pasta, for example. And although my program didn't have us limit carbs, like many do, we were told to avoid sugary things like fruit juice). I wouldn't worry about the carb level they're recommending, though, as not all programs are ultra-low-carb. Also, many of us are told to shoot for 60-80 grams of protein, but 110 isn't anything outrageous - and may be appropriate given the amount of calories and the macro percentages they're recommending.

Creekimp may weigh in here because I think her program was one that recommended higher calorie levels than most (I think some do now because they believe keeping calories a bit higher means your metabolism doesn't take quite the hit).

[Lahela 84]

2 hours ago, ThisMomOf5 said:

At my 1 month post op, I was told to eat 1100-1200 calories including 110 grams of Protein, 60g carbs, 45g of fat a day and no foods are off limits as long as I hit those targets. Pre-op I wasn’t a huge eater and these numbers are only a few hundred calories off from what I was eating. I gained weight as a result of insulin resistance and other health issues. I was also told that my 15lbs lost at 1 month was good but slower than most. At that point I had been stalled for a week.

Anyone else given similar recommendations? Did you lose as planned? I’m trying not to second guess my team but from what I’m reading, this seems like more than most people are told and doubt is creeping in. I’ve learned over the years that medical professionals are people too who make mistakes and nutritional advice seems to change (low fat vs no low fat, artificial sugars vs no artificial sugars etc) so I’m trying to see if other people’s experiences support this advice. After all, ultimately my health is my responsibility. Thanks in advance for any feedback you can offer!

I was watching a nutrition video by a Bariatric surgeon and he stated that if you are going to add in exercise and or weight lifting then you need more calories. Otherwise our bodies think we are starving and start to eat muscle not the stored fat first. If you are concerned I would honestly ask your surgeon for their input and schedule another appointment with the nutritionist. I was told 6 wks of no grains, no red meat, no shellfish or raw fish, no starchy veggies and no raw veggies, no butters or seeds and no fruit with seeds or skins. Basically the only fruit they recommended were canned pears, canned peaches or a banana. We were also advised to drink only Water, no juices, no additives. With a minimum of 1 Protein Shake per day. I am 1 day out from surgery and on the pureed/liquid stage for the next 2 weeks. Let us know how your plan is progressing.

[mil_unloaded 80]

I’m almost 3 months out and my dietitian wants me to still focus on fluids and Protein, and worry less about calories. I’m averaging around 800 a day. One day might be 650, the next might be 900. I haven’t passed 1000 yet post-op.

Most people have a stall around week 2-3. I did. I lost like a half of a pound, if that. My weight loss has been pretty consistent since then.

[LaoDaBeirut 158]

That was similar to the recommendations I got. I've been following it and losing consistently. Follow the advice you're given.

[ThisMomOf5 9]

40 minutes ago, LaoDaBeirut said:

That was similar to the recommendations I got. I've been following it and losing consistently. Follow the advice you're given.

This is what I was hoping to hear..that success is indeed possible this way. Thank you!

1 hour ago, catwoman7 said:

The kind of odd thing is that they told you nothing is off limits. That's true once you're in maintenance, or at minimum, a few months out - but early on we were told to stick to very nutrient-dense food (which would not include things like Pasta, for example.

Thanks for your response. I searched for over an hour last night before posting to find anyone on a similar meal plan. I guess I didn’t go quite deep enough

In reference to the excerpt from your post above. I thought about that for a while when she said it. I came to the conclusion and so far after a few days of sticking to those goals, I’ve realized that if I eat something like bread or Pasta I’d meet my carb goal pretty quickly and would have to make adjustments to the rest of my days intake. Same thing with fats. I guess it’s all about Portion Control.

[ThisMomOf5 9]

1 hour ago, Lahela said:

I was watching a nutrition video by a Bariatric surgeon and he stated that if you are going to add in exercise and or weight lifting then you need more calories. Otherwise our bodies think we are starving and start to eat muscle not the stored fat first. If you are concerned I would honestly ask your surgeon for their input and schedule another appointment with the nutritionist. I was told 6 wks of no grains, no red meat, no shellfish or raw fish, no starchy veggies and no raw veggies, no butters or seeds and no fruit with seeds or skins. Basically the only fruit they recommended were canned pears, canned peaches or a banana. We were also advised to drink only Water, no juices, no additives. With a minimum of 1 Protein Shake per day. I am 1 day out from surgery and on the pureed/liquid stage for the next 2 weeks. Let us know how your plan is progressing.

Welcome to the other side! It sounds like that video is in line with what I was advised. Thanks for the feedback!

[ThisMomOf5 9]

1 hour ago, mil_unloaded said:

I’m almost 3 months out and my dietitian wants me to still focus on fluids and Protein, and worry less about calories. I’m averaging around 800 a day. One day might be 650, the next might be 900. I haven’t passed 1000 yet post-op.

Most people have a stall around week 2-3. I did. I lost like a half of a pound, if that. My weight loss has been pretty consistent since then.

Thanks for sharing your experience. At 110 grams of Protein I feel like protein is the majority of what I eat. I also usually need to drink a 30g Protein Shake a day to make my goal.

[Creekimp13 5,840]

My group was actually involved in a study focused on upping calories sooner. I was encouraged to reach 1200 calories per day as soon as possible, and did so around week 3 after surgery.

I have not seen the study, but I was told by my doctor that people who eat more calories sooner will lose weight slower, BUT....statistically have much less regain later....the hypothosis being....this is because the metabolic set point is being re-estabilshed at a more robust livable caloric level.

I cannot speak for anyone's experience but my own, and can report observations of a family member who has also had bariatric surgery. My cousin is a few years younger, also had sleeve, and was on an extended restricted calorie plan. She ate 600-800 calories for months after surgery. She lost rapidly. She was appalled by the calories I was being encouraged to eat as soon as week 3. Gave me crap constantly that I would not lose the weight she had.

And at first...I was concerned she was right. She lost more weight than I did MUCH MUCH faster.

Eating 1200 calories a day, I lost slowly, but consistently. But I eventually reached goal.

I'm three years out, she's four years out.

I've maintained everything I lost and I eat around 1600 calories a day. If I go up five pounds, I don't have any problem taking it off by dropping my calories down to 1200-1400.

She's regained half of what she lost, and says she struggles to lose weight eating 1000-1200 calories a day. She blames the sleeve, and is planning to do revision surgery to RnY bypass.

My personal feeling...is that there could be something to this concern about metabolic reset at too low a calorie threshold.

Do I know that? Nope. People are extremely individual. This is a new science and there's a LOT we don't know, and even more that will vary by person, diet, and a dozen other variables.

But I do know that attitudes among bariatric surgeons regarding diet are changing at the major research universities....to favor higher calories sooner.

I'm guessing we'll know a lot more about how this all works out in the data.....in about ten years. LOL

[Deb9386 110]

The first few weeks I was advised to concentrate just on getting in the Protein and fluids. The suggested menu for when I started the puree stage came to about 800 calories per day. This gradually increased with the new menu plans, and at the 3 month stage post-bypass my nutritionist told me to aim for between 1000-1200 per day. I couldn't have physically taken in 1200 calories at the stage you're at. My weight loss has been steady with this plan.

[ThisMomOf5 9]

21 minutes ago, Creekimp13 said:

My group was actually involved in a study focused on upping calories sooner. I was encouraged to reach 1200 calories per day as soon as possible, and did so around week 3 after surgery.

I have not seen the study, but I was told by my doctor that people who eat more calories sooner will lose weight slower, BUT....statistically have much less regain later....the hypothosis being....this is because the metabolic set point is being re-estabilshed at a more robust livable caloric level.

I cannot speak for anyone's experience but my own, and can report observations of a family member who has also had bariatric surgery. My cousin is a few years younger, also had sleeve, and was on an extended restricted calorie plan. She ate 600-800 calories for months after surgery. She lost rapidly. She was appalled by the calories I was being encouraged to eat as soon as week 3. Gave me crap constantly that I would not lose the weight she had.

And at first...I was concerned she was right. She lost more weight than I did MUCH MUCH faster.

Eating 1200 calories a day, I lost slowly, but consistently. But I eventually reached goal.

I'm three years out, she's four years out.

I've maintained everything I lost and I eat around 1600 calories a day. If I go up five pounds, I don't have any problem taking it off by dropping my calories down to 1200-1400.

She's regained half of what she lost, and says she struggles to lose weight eating 1000-1200 calories a day. She blames the sleeve, and is planning to do revision surgery to RnY bypass.

My personal feeling...is that there could be something to this concern about metabolic reset at too low a calorie threshold.

Do I know that? Nope. People are extremely individual. This is a new science and there's a LOT we don't know, and even more that will vary by person, diet, and a dozen other variables.

But I do know that attitudes among bariatric surgeons regarding diet are changing at the major research universities....to favor higher calories sooner.

I'm guessing we'll know a lot more about how this all works out in the data.....in about ten years. LOL

13 minutes ago, Deb9386 said:

The first few weeks I was advised to concentrate just on getting in the Protein and fluids. The suggested menu for when I started the puree stage came to about 800 calories per day. This gradually increased with the new menu plans, and at the 3 month stage post-bypass my nutritionist told me to aim for between 1000-1200 per day. I couldn't have physically taken in 1200 calories at the stage you're at. My weight loss has been steady with this plan.

Thank you both so much! This was the affirmation I was looking for from real people who experienced it. My surgeon and NUT both mentioned that this was my opportunity to metabolically start over. I didn’t fully understand what they were trying to say but the lightbulb has gone off with your explanation Creekimp!

I tend to overthink and worry too much! I can comfortably eat quite a bit before I feel full and surprisingly have no issues meeting these goals. Seafood has been my best friend! I also lost 5 lbs in the 5 days after I started following my new plan. Going forward I will try to trust this process and enjoy the ride!!😊

[MiraMar 4]

1 hour ago, Creekimp13 said:

My group was actually involved in a study focused on upping calories sooner. I was encouraged to reach 1200 calories per day as soon as possible, and did so around week 3 after surgery.

I have not seen the study, but I was told by my doctor that people who eat more calories sooner will lose weight slower, BUT....statistically have much less regain later....the hypothosis being....this is because the metabolic set point is being re-estabilshed at a more robust livable caloric level.

This is so interesting, thank you for sharing!

I have been wondering what evidence some of the differing post-op diet recommendations were based on (my recommended diet is also a bit different than what I see recommended here) so it's fascinating to hear that there is so much ongoing research, especially on the science around regain.

[LaoDaBeirut 158]

One thing I think is an actual problem within the WLS surgery community is all the bragging about how little someone can eat. I've seen it a lot but not so much on this site. Someone will say what they are eating and other people chime in with oh I can't eat that much or I cant have 1,000 calories that's too much. It's a weird flex and I think makes people freak out they're eating too much.

The truth is we all have slightly different needs following surgery. I'm a foot or more taller than some other women having surgery. I'm assuming that we would have very different caloric needs even if we are all losing weight. Some people are very active and others not so. I tend to trust the experts and just do what they tell me. Clearly if I were good at doing this myself I wouldn't have ended up here.

[The Greater Fool 2,022]

Creekimp13 made some excellent points. A few studies would come in handy.

I've always been shocked how so many surgeons and patients approach the post-op experience as a crash diet. Lose as much as possible while eating as little as possible so you can lose weight as fast as you can. Then when you've lost your excess weight you (hopefully) learn the new appropriate way to eat. Or, as so many people do, return to their old ways and regain the weight.

My Doc's plan was to get on the 'forever' eating plan quickly. You learn new habits with the positive feedback of losing weight. All that success makes the plan solidly a habit. Then when you reach your goal (or stop point) you adjust very slightly to maintain.

Anyone can do anything for the short term, it's why diets work for a time. It's the long haul that we need to work on. That so many programs make these two phases completely different I think sets a lot of people up for failure, the same failure diets setup preop.

But, I would never say don't follow your surgeon's plan. Just remember that returning to the old "normal" will yield the same results as it did pre-op.

Edited March 27, 2021 by The Greater Fool

[ThisMomOf5 9]

2 hours ago, LaoDaBeirut said:

One thing I think is an actual problem within the WLS surgery community is all the bragging about how little someone can eat. I've seen it a lot but not so much on this site. Someone will say what they are eating and other people chime in with oh I can't eat that much or I cant have 1,000 calories that's too much. It's a weird flex and I think makes people freak out they're eating too much.

The truth is we all have slightly different needs following surgery. I'm a foot or more taller than some other women having surgery. I'm assuming that we would have very different caloric needs even if we are all losing weight. Some people are very active and others not so. I tend to trust the experts and just do what they tell me. Clearly if I were good at doing this myself I wouldn't have ended up here.

This!! Wether it’s bragging or not after reading so many posts like you described, I actually asked my surgeon if something was wrong because I’ve never had nausea, I can eat more than 1/2 cup without getting sick, , I can eat dairy, and in fact everything seems to agree with me. He smiled at me and said, why, is that what you wanted? Then he told me not to compare myself to others. Of course then I started this post 😝