Keto And Calories
Your body won't "become accustomed" to 500-600 calories unless you're end goal is to weigh 75 lbs. Just because your stomach is smaller doesn't mean your body requires less calories to maintain a certain weight. I am currently maintaining at 165 with a daily calorie intake of 1400-1600 on the Ketogenic way of eating.
I stayed at 800-900 after about the 5 month mark on Keto and still lost weight well. Depending on how much you weighed when you started, and how much you want to weigh at goal, will depend on how fast you lose on the increased calories.
Sounds like the bigger issue is your binge eating. If you haven't already sought out therapy for that, I would recommend you do. Binge Eating Disorder is a real thing, as many here can attest, and if you think you're going to "eat until the point of pain" after your stomach is fully healed, then it doesn't matter whether you eat Ketogenic or any other way, you're going to do damage and you're probably going to consume more calories than your body needs to maintain your weight. That is the bigger issue. Your sleeve won't "stretch," but it does heal and the swelling goes down until eventually you are able to eat the amount that your sleeve truly holds. That takes a few months. If you continually eat until you feel pain, you may stretch it a bit, but you're more likely to cause leaks and that is deadly.
If you can get your binge eating managed, then the increased calories you will need to maintain weight won't be a problem...Keto or not.
As for controlling calories...Keto does not require that, per se. ALL ways of eating require moderation in calories, that's just science.
Calories In < Calories Burned = Lose Weight
Calories In = Calories Burned = Maintain Weight
Calories In > Calories Burned = Gain Weight
In order to decide what your macros are for Keto, though, you do need to figure TDEE (Total Daily Energy Expenditure) in order to determine how many calories it takes to maintain your weight. Otherwise, you would have no idea what 75% fat would be...75% of what? That is really about it for Keto and calories. Once you have determined your ratios and the associated grams of fat/protein/carbs, then it's those grams you work with on a daily basis. A lot of Keto people just then make sure they only buy and cook things that fit within those measurements, and don't bother with accurately counting calories. I still measure, weigh, and track everything I eat. Personally, I believe it's the only way to maintain weight loss after WLS and keep it off. When we stop, is when the weight goes on. If we knew when to stop eating because we've had enough (as normal weight people who have never had weight issues seem to), we would never have gotten to be SMO in the first place. But we don't, so we count our calories, track, etc.
Here is a great calculator that will figure your TDEE and help with your associated macro targets:
https://damnripped.com/tdee-calculator/
I think I rambled a bit here, but I hope this makes sense for you :)
Great explanation! Thank you! I haven't heard anyone talk about this, but as I mentioned in my other posts, I'm feeling some heaviness or discomfort before I get the 2 ounces of protein in per meal. I tried earlier suggestions of Greek yogurt as well and the discomfort still happens even though it should slide through. Even water with lemon can do it, and I can't drink fast or take huge sips. Sometimes it's only a mild discomfort which I take as my new fullness signal so I stop eating. What happens then is that 15 or 20 minutes after I stop eating, that heavy discomfort intensifies to almost a painful feeling even though I didn't intend to eat to that point. I don't want to get into the habit of needing that feeling to stop. I'm now aware of the fact that I will be an extra tough case since I was a revision from the Lap Band. I had just been going through the day eating whatever I was able to fix up quickly due to lack of energy and patience. I'm going to start paying extra attention to meal planning the day before so that I can do the calculations you mentioned. Thanks again!
At 3 months post op, 2 ounces of protein sounds right. However, I don't believe you should be feeling pain and discomfort, that doesn't sound right to me. Have you discussed this with your surgeon? Especially if just drinking is causing it as well, I think you definitely need to check with your surgeon's office ASAP.
Yes, the surgeon knows. The program has a messaging system, and I had been informing the surgeon, the PAs, the NPs, and the nutritionist about everything including the discomfort, weakness, and slow loss. I just went for my 3 month postop visit. They seem to think everything is due to it being a revision. Since I was a revision I had both a preop EGD and CT scan to make sure everything was ok in my esophagus and stomach and they were fine. I requested the sleeve surgical operative report which says nothing about increased scar tissue in the area intended for the sleeve. I did have adhesions around the outside of the Lap Band which were released when it was removed. No complications. I do remember that I had severe pain postop in the recovery room which took forever to control and which shot my blood pressure sky high. Prior to that my blood pressure would go up and down with my weight but I hadn't been on chronic blood pressure medications. Hopefully nothing is wrong inside. As far as they are concerned, everything I'm experiencing now is due to it being a revision from Lap Band to sleeve and it will all resolve with time. I truly hope so.
