Weight has dropped below goal - help!

Creon is the commonly known name for the digestive enzyme, but you should only add if you really do get too low.

As long as you are still above an 18.5 BMI....ride it AS low as you can. I got "too low" at 121...and without changing what I ate, regained about 20 lbs this year.

Liz

While 143 seems high, everyone is commenting how small I look - I have always weighed more than I look!  I don't mind staying where I am now, but I just don't want to keep going down - I have so much saggy skin as it is!!   I can't imagine being an 18.5 BMI - I am just thrilled to have it in the normal range at 24.5.  

I am interested in hearing more about the weight gain  and what triggers that...besides the obvious going back to bad habits, I mean!

I am 5'7" and weigh about 134, though I saw the 131s just a couple weeks ago.  I havent calculated my bmi.  I do know I would have been happy at the 170s!  I had WLS for my health, not to be skinny.

i still get comments about being too skinny, but personally, I think its more of a reaction to how much "skinnier" I am today, then what I looked like before.  I dont feel too skinny.....still got a belly!  

I'm not sure what your height is, but I think you are probably right where you should be with your loss.  No need to try and fully stop it yet, but you can add carbs to slow it down.  

If you are 143 and a size 10, don't worry at all.  You and those concerned others have never seen you at a normal weight.  And your fat will still redistribute some too.  If I was in your place, I would be thrilled and certainly not looking for ways to stop the loss.  Now if you get down to say a BMI of 20 or so, it's time to think about adding some carbs.

Regain can be from bad habits but some of it is because we do absorb more further out.  Your body will always try to adapt to what you did to it.  The small intestine adds villi or even grows a little.  This is why people regain with the RNY.  Around 2 years post, their malabsorbtion is pretty much gone.  We have so much bypassed that we never lose all our malabsorbtion but we do lose some.  Hence the bounceback.  It will come.  If you make it down to about 120, you will probably end up right where you are now.  And you will probably try to get back down to 120.

Next the skin issue.  The good news is your skin will continue to shrink slowly for quite a while.  The bad news is that you will never look as good as a person who was never heavy.  Wait and see what you end up with.

Thanks for the info Patty. 

I have heard from all the old timers that there is going to be a regain of 10 to 20 lbs at 2-4 years later as our stomachs adjust/grows more villa to absorb more nutrients.  And losing that regain is much more difficult than it was to loose the weight originally.

Honestly, I'd add a protein shake or two to your day. Protein is a miracle food, if you need to lose weight it'll help, likewise it'll help you maintain or gain if needed. 

It should also allow you to get the nutrition without eating as much, which is annoying to do. I also have a smaller stomach and get so annoyed when I have to eat all the time. 

What are your labs like? 

Creon is an option but honestly, I don't think you are underweight at all. I understand the concern but most times our bodies are way smarter than ours. :)

 

I don't think I am underweight, I just don't want to get any smaller than I am now.  I was always a nice size 12 and that is where I guess I feel like me.  I actually miss my butt!  Maybe my boobs and butt will fill out again if I gain back!

 

I agree that eating all the time gets old - the other day we were out bike riding and shopping and visiting my son in Monterey and I kept having to stop to eat...

My labs are quite good - I upped my protein after my 6 month set and I have also had to up potassium - all else are at good levels.  My doc has never had a DS patient but he has had many RnY patients and read some stuff I passed on to him, so I trust his reading of the results every 3 months.

One of the "problems" I see a lot is people who accept their weight and don't strive to get further down. They become complacent because they can now shop in normal size stores and they feel more normal, yet they are still overweight. I'm not saying this is you by any means but it's easy to think, "hey I'm not a size 26 anymore and 14 is normal I'm good here" and then stop working/moving forward.

I wear between a size 4 and 8, depending on the store. I decided early one to take it as far as it would let me and not just get to a point where in the past I felt normal. For me, if I'd done that would have been 25 pounds up from where I am. It took me a long time (months) to get over that weight hump too because I'd sat there for so long pre-op. 

I don't say this to be critical, just that our mind sometimes needs to catch up. I don't think we should strive to be supermodel thin but we should also plan for the future too. :)

Trust your DS!!! 

Try drinking more protein shakes, like bodybuilders do when they need to gain weight.  Actually, the DS nutrition protocol is very similar to what bodybuilders and athletes do.  Also very similar to the Atkins diet.  I'm not sure why your stomach didn't stretch as it was designed to.  Perhaps your surgeon made yours extra small. Perhaps you have not included enough bulky foods in your nutrition plan to help stretch your stomach.  Unfortunately, that part of the DS is not reversible, so you'll have to work around it, with extra shakes and building up your intake of bulkier foods. My new stomach was only 2.8oz immediately post-op,  according to the surgical report.  I can now comfortably eat 8 to 10 ounces of food in a sitting, depending on the density of the food.

I'm almost 5 years out, and here's what happened to me:

My PCP  limited me to an absolute minimum  weight of 160.  I started out on surgery day at 397.

I usually weigh myself every two weeks, and one morning I got on the scale, and after having been stable at 182 for a couple years, I was at 168 - just 8 pounds away from my minimum.  I have about 15 pounds of excess skin with adhescient fat deposits,  which I'm working on having removed, so a drop like that is scary!) 

I would suggest drinking more protein shakes. NUTs will tell you you will ruin your kidneys with so much protein, but think about it - as a DSer, you're only absorbing 50-60% of the protein and complex carbs you take in, except for simple carbs and simple sugars. - it's 100% for those. The carbs from the milk will help.  Ice cream is good for weight gain.  Also, if you like crunchy snacks, get some Kashi in the *red box*.  It has protein and carbs.  It is my go-to snack, as well as breakfast cereal. 

My surgeon put me on Creon 24000 units.  That is basically a pharmaceutical reversal, as it adds digestive enzymes in the stomach, to replace those from the pancreas and liver, which are re-routed to the common channel. I was warned that Creon might make me gain weight, but that has not been the case for me.

Get your surgical report  or ask your surgeon how long your common channel is.  Shorter common channels - mine is 75cm- seem to retain what I call the "runaway freight train" properties of the DS, which can be revved-up at any time by carb-shocking with simple carbs. Apparently, I hadn't paid enough attention to the food combos I was eating, and though I noticed my clothes getting a little sloppy, it wasn't enough to be concerned about, to me.   When I went to my PCP visit, she was even shocked, and told me I needed to stop losing. Exercise to build muscle will also help, and I know it sounds contrary to what exercise is supposed to do, but the weight machines are non-aerobic.  It's the aerobic exercise that burns fat as fuel. Muscle weighs more than fat.  That's why it takes so much fat to become "obese".

In summary - More complex carbs, shakes as supplements and some weight training.

Let me add this caveat:  I am neither a doctor or dietician (at least not yet!).  This is simply my own solution based on what I've already learned as a DSer and in my Dietetics classes. It works for me, but there is no guarantee that it will work for you.  The DS is truly a customized surgery, and behaves differently with everyone.  The absorption rates are simply an average, gleaned from someone else's medical research.  YMMV (your mileage may vary).