"Behind" program guidelines

[Sleeve_Me_Alone 656]

Alright, y'all, I'm 6 weeks post-op and feel great! I've had a very smooth recovery, and am truly grateful for that. Two weeks ago, I got an update from my dietician about week 4 & 5 phases, including suggested meal schedules and calorie intake. I was a little lower than her goals, but figured I was close enough that over the course of the 2 weeks I would get there. Today I got the week 6 & 7 guidelines and I'm realizing I'm further "behind" than I thought I was. Her guidelines include 3-4 meals a day, 3-4oz each, with an overall 1,200 a day caloric intake (70g Protein goal). I'm still sitting at 800-900 calories with 2 meals a day and a Protein Shake or two, which does allow me to hit my protein goal every day. However, if I try and up my meals to 3 a day, I feel super full and uncomfortable most of the day, and then struggle to get all my fluids in because I'm so full. Then, if I skip the shake to compensate, I don't come close to my protein goal.

On top of that, I'm struggling with the mental piece of wanting to "ride the wave" of not being hungry as long as I can. Its so tempting to say, well I'm not hungry so I might as well make the best of it and not eat while I can get away with it! Weight loss will never be easier than it is right now... blah blah blah. I realize that's unhealthy, borderline disordered thinking and I recognize it and I'm working on it. Just adding it in there for context, that this is super freaking hard!

I have an email out to my dietician, but would also love some personal experience on how to up intake when you're not hungry and additional/bigger meals is still difficult. Is it even that big of a deal to keep pace with my program, or will it all sort of work out in the end? I do NOT want to slip back into extreme restriction type behaviors, I want to do this properly and in a way that creates a healthy, sustainable lifestyle. Any advice to that end is welcome!

[lizonaplane 1,612]

I'm so jelly that you're not hungry. I've been hungry since the first week.

But.... all plans are different. Yes, ideally you should follow your surgery center's plan, but don't freak out if you can't eat as much. Some plans are much more restrictive and say only three meals a day with no Snacks, and other want you only eating 800 calories or whatever... I had my surgery a week before you and I'm not eating 1200 calories a day. I'm at 700-900. Of course, my surgery center didn't give me a number of calories to eat, so I'm just eating until I'm full 3 meals and 2-3 snacks a day. I usually but not always have a Protein Drink in there because otherwise it's hard to get my Protein goal (I was told 80g to keep from being so hungry).

Ugh... it's so hard to know what the right answer is. Please post what your dietician says!

[ShoppGirl 4,740]

Many of the programs don’t give calories like lizonaplane said. Mine didn’t either and when they do they vary so much at each stage. I wouldn’t force it if I was full, personally if you are getting a reasonable amount in you should be fine. Getting your Protein is most important. I think if there is one thing every plan stresses it’s protein first. You should be able to eat a little more over time until you get up to about a normal serving size. I am almost 8 months and that’s where I am now. Well almost one serving. The NP said I got there a little sooner than most and she wasn’t concerned so it’s not an exact science.

[ColieCallwell 129]

It is so hard to give advice when every surgeon has a different plan! 1200 calories a day so soon out from surgery seems high. I think they want you getting your Protein to mitigate side effects (hair falling out, no energy, not looking "good"). My surgeon's office had me on pureeds til I was 9 weeks out, and emphasized just doing shakes if meals were too much. Last week, I had my 2 month appointment and was told I should be getting 80g of protein through Protein Shakes alone, (and the protein HAS to be Bariatric Advantage or Unjury - yuck, no Isopure which I can actually tolerate), and 120g of total protein daily. Well, I frickin hate the protein shakes, and I was doing really good getting in 80g from real food, (and the office was quite pleased with the weight I've lost so far). My nutritionist said 500 to 700 calories a day was good, not to focus on macros, just to focus on getting my protein. Because those shakes are so high in calories and carbs, if I drink protein shakes, my calories are closer to 900 per day and my carbs are close to 100g (which seems very high). So I'm just going back to what I was doing.

Sent from my SM-N976V using BariatricPal mobile app

[pintsizedmallrat 472]

I had surgery a week before you and I'm still struggling to pass 200 calories a day. I'm not hungry. I have to force myself to eat. I'm happy with the weight I'm losing, I'm taking a Multivitamin, Iron, and Calcium every day, but I feel sooooo weak all the time.

[ms.sss 15,490]

TBH, I didn’t once reach my nutritionist’s food goals for me until probably 2-3 months AFTER i reached goal. I just did what I could.

You’ll find out in the coming weeks/months what works for you. Probably no need to force something that isn’t doable at your stage. But maybe that’s just me.

What have your labs been like? Energy levels?

[Arabesque 7,194]

I only eat about 1200/1300 calories a day at 2 1/2 years out. I was barely eating about 800 at goal. But that was me & we are different. I remember saying to my surgeon I can only eat what I can eat & he agreed with me. Probably because my blood work was always good so I was getting all the nutrients in I needed even if I wasn’t eating much calorie wise.

I also wasn’t hungry for ages - well into my second year & I am grateful for that. It made me look at food differently - as something I need not just want. I still have the odd days or times I’m not hungry but I recognise I still need to eat something for my body to function effectively. Didn’t want dinner last night so I grazed on a tub of high Protein yoghurt for about an hour so I still met my protein goal for the day.

Yep, there’s a lot of different plans out there. Mine didn’t have calorie requirements either only portion size. But you will find you will be able to eat more as you progress. You may find grazing on meals easier than trying to eat all your meal in one sitting. Nothing wrong with taking an hour or more to eat a meal - I can still take an hour plus to finish a meal. Are you tracking your food & is your dietician reviewing it with you?

Glad you’re feeling great & congrats on your progress so far.

Edited November 3, 2021 by Arabesque

[Sleeve_Me_Alone 656]

14 hours ago, pintsizedmallrat said:

I had surgery a week before you and I'm still struggling to pass 200 calories a day. I'm not hungry. I have to force myself to eat. I'm happy with the weight I'm losing, I'm taking a Multivitamin, Iron, and Calcium every day, but I feel sooooo weak all the time.

Have you reached out to your dietician? That is really not sustainable and could result in some long term health issues. I know its hard, I am right there with you, but you HAVE to take care of yourself and nourish your body well in order to be successful. At 200 calories a day, you are going to be rapidly losing lean muscle with is starvation, not weight loss. Please reach out for support!

[Sleeve_Me_Alone 656]

Thanks all for the encouragement and wisdom! You all helped put my mind at ease and I truly appreciate the input.

My dietician is in agreement with all of you, that I'm on the right track and should stay the course. No need to strive for "goals" that my body isn't ready for, just focus on fluids and Protein and expanding my food options based on the program. She did suggest trying 3 smaller meals a day, instead of 2 larger ones, just to help get in the habit of eating more times a day, even though it won't have an immediate impact from a calorie/protein perspective; more a behavioral change than nutritional. So, I'll give that a whirl for a few days and see how it goes!

ETA: First post-op labs are next month. Nothing pre-op was a concern, so we'll see if I'm holding steady when I check in.

Edited November 3, 2021 by Sleeve_Me_Alone
ETA

[catwoman7 11,210]

my program didn't talk about calories at all, but I know a lot of people seem to eat in the 600-800 calorie range for most of the first year (after the first month or two, of course - when it's usually lower). HOWEVER, I'm hearing more about programs who want their patients to eat more like 1000-1200 pretty early on, so what your dietitian is recommending is not unheard of. I think it has to do with metabolism or something. Or being less restrictive from the get-go so people are more likely to stick to it and/or not have as much of a regain or something (I haven't paid much attention to the rationale since I'm pretty far out - I just know this has come up before on this site). Anyway, ask her.

[vikingbeast 987]

My nutritionist has me on a range of 1000-1400 calories a day. Usually I struggle to get the 1000 calories. But I will say that when she added some carbs in, I felt immediately better. I'm not gonna go eat a tuna sandwich, but a couple of spoonfuls of mashed potatoes or a little rice with my Korean BBQ ground turkey goes a long way toward both good energy (I have an active lifestyle) and the dread Constipation issue. I haven't had to take any Dulcolax since the carbs were added in.

[lizonaplane 1,612]

1 hour ago, vikingbeast said:

My nutritionist has me on a range of 1000-1400 calories a day. Usually I struggle to get the 1000 calories. But I will say that when she added some carbs in, I felt immediately better. I'm not gonna go eat a tuna sandwich, but a couple of spoonfuls of mashed potatoes or a little rice with my Korean BBQ ground turkey goes a long way toward both good energy (I have an active lifestyle) and the dread constipation issue. I haven't had to take any Dulcolax since the carbs were added in.

I would like your Korean BBQ ground turkey recipe plz and thank you

[vikingbeast 987]

56 minutes ago, lizonaplane said:

I would like your Korean BBQ ground turkey recipe plz and thank you

It is seriously so simple I'm embarrassed to call it a recipe... brown off some ground turkey with a little salt in a skillet, with just a touch of oil so it doesn't stick (spray works too). Then I add bottled Korean barbecue marinade. It's 30 calories 7C 0F 0P per tablespoon and I usually add 6 tablespoons per pound of turkey, but a pound of turkey lasts a LONG time for me. The one I buy is CJ Foods Korean BBQ Bulgogi Marinade w/Apple and Pear but any will work.

Then I just sprinkle some sesame seed and chopped green onions on top, and eat it with a tiny bit of rice (like 2 Tbsp or 1/8 cup) and a piece or two of kimchi from a jar.

[Queen ApisM 427]

This sounds like me. I had my two month check in about 2 weeks ago, and the nutritionist said I should be at 1000 calories a day, especially since I was adding in moderately intense exercise again. I was averaging 600-700 at that point! They also wanted me to ease off the shakes (I was having one shake a day) in favor of food, though Protein Powder was definitely ok to use. She emphasized that WLS isn't supposed to be very low calorie forever, otherwise other problems arise. I assume it is metabolism concerns.

I've managed to get it up to more like 800-850 calories on a really good day, but it is hard. I'm just doing the best I can - yesterday I managed to get to 1000 for the first time but wow that was a project. I feel like I am eating or drinking or waiting to drink all day long. I'm keeping the one shake a day because honestly that is an easy 160 calories, otherwise I need to figure out another snack to add to the rotation.

I'm just doing the best I can, without adding in unhealthy things. So, adding in good carbs and listening to my body as much as I can. Just focus on doing the best you can. Good luck.

[vikingbeast 987]

16 minutes ago, Queen ApisM said:

This sounds like me. I had my two month check in about 2 weeks ago, and the nutritionist said I should be at 1000 calories a day, especially since I was adding in moderately intense exercise again. I was averaging 600-700 at that point! They also wanted me to ease off the shakes (I was having one shake a day) in favor of food, though Protein Powder was definitely ok to use. She emphasized that WLS isn't supposed to be very low calorie forever, otherwise other problems arise. I assume it is metabolism concerns.

I've managed to get it up to more like 800-850 calories on a really good day, but it is hard. I'm just doing the best I can - yesterday I managed to get to 1000 for the first time but wow that was a project. I feel like I am eating or drinking or waiting to drink all day long. I'm keeping the one shake a day because honestly that is an easy 160 calories, otherwise I need to figure out another snack to add to the rotation.

I'm just doing the best I can, without adding in unhealthy things. So, adding in good carbs and listening to my body as much as I can. Just focus on doing the best you can. Good luck.

This. So much this. I made a gorgeous egg scramble with mushrooms and cactus, and only got down half of it. Blah!