Am I doing this all wrong?

[canadianpopcycle 77]

Hello!

I hope some people can give some advice! I have been stewing on this for a number of weeks, and I am not really sure what to do. I will start by saying that my program is in Canada, and it is set up a bit different than most Americans. I go to a bariatric clinic that includes the psychologist, internal medicine doc, Dietitian, Nurse. The surgeon you are referred to after you have jumped through the hoops with the other professions. You are assigned the surgeon who does your surgery, for the most part, you don't get to shop for one...and they have little to do with the Diet/Medical Part (vitamins, labs, etc). The surgeons are general surgeons that obviously know how to do these surgeries, but they are not solely bariatric surgeons. So essentially, if I have questions I go to the bariatric clinic, and not the surgeon.

The problem is, I hate my Dietitian. I don't feel like I can ask her anything without her being weird, and control freaky about everything. She has argued with me over my food logs (aggressively suggesting berries instead of the banana I ate everyday pre-op), She got upset with me for taking psyllum husks and Omega 3 after surgery because "WHO TOLD ME TO DO THAT??!". I asked her about when my Protein requirement would reduce (since I am losing weight obviously), and was told never because the protein requirement was based on my height, and not weight. (????). When I ask what calories I should be at, she won't answer and tell me my calories need to be higher. She also made a point to tell me that my weightloss will greatly slow down now (at my 3 month appointment).

I was never a big/fast loser since starting this. Other than the first 2 weeks after surgery...I average out at about 2.5 pounds a week. In my program, regular food started week 4 after surgery. Once I went to solid food at week 4, I eat between 1100 and 1300 calories. I have yet to eat out, the 'worst' thing I have had is a very small bite of candy to taste it. There is no forbidden food except for carbonated drinks...and obviously they recommend staying away from overly fried, processed, sugary things.

Prior to surgery, the last time I had lost weight sucessfully was in 2016 when I went to the gym 6 days a week and tracked all my calories. I used MFP and fitbit. I ruined my knees in the process of that (a whole other story lol). I still use MFP to track food. So right now, MFP has 1300 calories to lose 2 pounds...and I am still a bit over 250. How in the world am I going to keep losing weight if I am supposed to eat more?

Currently, my body is doing this thing where I lose 2.5 one week....0.7 the next....2.5 the next...I feel like I stall every 2nd week or so. The dietician doesn't help at all. She always rags on me to eat 5-6 times a day. I get all my protein in, in those 3 meals and I currently still don't experience a hunger sensation at all...so why would I eat more? She wants me to eat more and I feel like what I am doing is okay. I told her I would add more Snacks if I need it, and she doesn't like that.

I am at 5 months out...I feel like I am trucking along...but then I get really worried that I am not going to continue to lose weight, especially when she is on me to eat more and more often when I frankly don't want to. Everyone wants to believe that they have some tailored medical diet...and we don't. Every single program is done by an expert and they are all different from each other...and it really annoys me when people say 'follow your program'...when it seems every doc has a different idea of what would be successful., and nothing is standardized.

Am I too set in CICO that I am frustrating myself? How can I continue to be successful and get to the lowest reasonable point that I can?

[NovaLuna 710]

Is there a way to ask for a different dietician? Because she sounds like an absolute nightmare! My dietician is nice and encouraging and if I end up eating something off plan she just tells me that it won't hurt me if it happens as long as it doesn't become a habit or something I do all the time. She tells me every time she sees me (usually when I'm dealing with a stall) that I'm doing great and as long as the trend is downward that no matter how slow the loss is, I'm still losing and that's that what matters. My dietician has me eating 1200-1400 calories and I'm almost 19 months out. When I was 5 months out I think I was probably eating about 800-1000 calories. I think your own dietician is pushing you to eat too much too fast, imo. I would see if it's possible to ask for someone else. I haven't gone to my own bariatric clinic since my 9 month appointment because there is this front office lady that kept rescheduling my 12 month appointment and pissing me off. She made my stress go from 0-100 pretty damn fast and was bugging me about my labs and how they hadn't received them and how she wanted me to call the lab and have them fax my paperwork over, which I'd done, so I kept having to tell her to do it her damn self because I'd already called them and they'd re-faxed it twice already so something was getting lost on their end and they needed to deal with it. Her response was to tell me they needed to reschedule me so I just never rescheduled after about the 9th time because she pissed me the hell off! I get stressed with just the idea of having to call the bariatric doctor because if I get her on the line I will hang the damn phone up! That's why I never made my 18 month appointment and just relied on my PCP to do my labs because of that b*tch! I wish I'd gotten her name on the multiple times she'd called me so I could report her for her incompetence! So yeah, I'd ask for a different dietician, personally.

[Arabesque 7,314]

You need to request another dietician. There are good ones & not so good ones about but you have to find one you’re comfortable with & you feel has your best interest at heart. Mine wasn’t great but she was always supportive, would explain things & made some useful suggestions about things I could try in my diet.

I can understand your dietician’s concerns about the psyllium husks - they can be too coarse to eat in the beginning & they tend to swell. If they swell in your tummy they’ll fill you up & you won’t be able to eat as much of the nutrients you need. (Look for non swelling soluble fibre to add to your diet.) But she should have explained this to you. Berries tend to have fewer carbs, less sugar & are lower in calories than bananas & bananas can cause constipation (which we already battle with). Again she should have explained this to you. The bananas & psyllium can be added back to your diet as you progress.

Your weight loss will slow as you get closer to your goal & your weight loss will vary week to week. Everyone experiences fluctuations when losing & when maintaining. (I fluctuate about 2lbs in maintenance.) As long as your weight loss trend is going down you’re doing great.

My Protein goal while losing was 60g. In maintenance I was told it should still be 60g. By my current weight it should be about 40g based upon the 0.8g per kg of weight recommendation. I average about 55g.

There is no right or wrong way to consume your calories & meet your protein goals. Some eat three meals a day, some snack, some graze on smaller meals, some do combinations. I had two Snacks a day (afternoon & after dinner - fruit, cheese &/or yoghurt) from about month 3 or so. Helped me get my protein in. I still snack about 4 times to get my protein & calories in or sometimes I graze - finish off an earlier meal. Some need more calories some fewer. I eat about 1200 to maintain my current weight but I’m not overly active, am in my mid 50s & have a smallish frame. I was barely eating 900 calories when I hit my goal at 6 months. But that was me. My dietician was always happy with my food choices & eating habits.

We’re all different. You have to find what works for you in regards to diet & eating habits. That’s what your dietician should be helping you to discover & advising you upon while you’re losing & then in maintenance.

I hope you’re able to find a better, more supportive dietician.

[Tracyringo 503]

Sorry you are having issues with dietician . Do you have to see one ? I never did after I had the surgery. I used the guidelines given and hung out in forums and did Youtube videos on what are you eating 3 months out ect ect. Those videos were very informative. If you have to keep seeing one get a different one. You really dont need the extra stress.

[Wahinebythesea 49]

14 hours ago, NovaLuna said:

I'd already called them and they'd re-faxed it twice already so something was getting lost on their end and they needed to deal with it.

I had the exact same problem - hospital said "we faxed it, they lost it" and surgeon's office said "they didn't fax it".

You may have outgrown this problem by now, but for anyone else who runs into it, I suggest requesting the results (on paper) from the lab (usually via Medical Records) and delivering them to the surgeon's office in person (when you're going there anyways). If you're comfortable with it, you can photograph the pages with your cell phone and email them.

That solved the problem for me.

Pro tip: It's usually the surgeon's office - not Medical Records - that screws up. Keep a copy of the results just in case you need to deliver them more than once

Edited August 22, 2021 by Wahinebythesea

[Plsmi7th 6]

3 hours ago, Wahinebythesea said:

I had the exact same problem - hospital said "we faxed it, they lost it" and surgeon's office said "they didn't fax it".

You may have outgrown this problem by now, but for anyone else who runs into it, I suggest requesting the results (on paper) from the lab (usually via Medical Records) and delivering them to the surgeon's office in person (when you're going there anyways). If you're comfortable with it, you can photograph the pages with your cell phone and email them.

That solved the problem for me.

Pro tip: It's usually the surgeon's office - not Medical Records - that screws up. Keep a copy of the results just in case you need to deliver them more than once

I was just about to drive over my H&P to the Surgical Office as well. They were adamant that my PCP’s Office didn’t send them…then miraculously after attempt # 3, someone finally received it! I’m sure the other 2 are sitting in a stack of discarded papers somewhere in their office!

[Plsmi7th 6]

19 hours ago, canadianpopcycle said:

Hello!

I hope some people can give some advice! I have been stewing on this for a number of weeks, and I am not really sure what to do. I will start by saying that my program is in Canada, and it is set up a bit different than most Americans. I go to a bariatric clinic that includes the psychologist, internal medicine doc, Dietitian, Nurse. The surgeon you are referred to after you have jumped through the hoops with the other professions. You are assigned the surgeon who does your surgery, for the most part, you don't get to shop for one...and they have little to do with the Diet/Medical Part (vitamins, labs, etc). The surgeons are general surgeons that obviously know how to do these surgeries, but they are not solely bariatric surgeons. So essentially, if I have questions I go to the bariatric clinic, and not the …..

Sounds like a her problem, not a you problem. I would keep doing what you’re doing as long as you’re getting your Protein and fluid goals in, but it definitely sucks that you can’t rely on her for any other questions you have 😒