Need to keep myself honest....

My surgeons plan is often quite a bit different than the average.  I have a 60g protein target, but no targets for carbs or fat. 

 

Carbs are not discouraged. Refined carbs are discouraged. We are allowed fruit, and strongly encouraged to eat lentils, beans, etc. In fact, my surgeon does not believe in the "protein first" model (this often gets people fired up), but believes in a "veggie first" model.  He is ok with animaln protein, but encourages us to eat at least one non-animal protein a day (which will invariably lead to high carb intake)  

 

Im addition, unlike a lot of plans, dairy is discouraged as are all grains (my steel cut oats were an exception he made for me as I transitioned to maintenance, but that is the only grain I eat). No rice (even brown rice), no pasta, no bread, no crackers of any sort.  No refined sugars (no white sugar, brown sugar, honey, shave, maple syrup, etc).  I am also supposed to avoid processed foods.

 

I understand your perspective, as I know what you are saying better aligns to the more conventional WLS diet. This diet is the one I've followed since I transitioned to normal foods post-op. Fruit has been an instrumental part of my diet from the very early stages. 

 

Im happy to report I has a very good day. I ended the day with 1,126 calories and 77g Protein. 

 

Thanks again to everyone for for their support!

I don't see anything wrong with fruits...Until the person complains about being hungry and start gaining... then one may want to look at a diet and see if anything in it may cause that.  

I know that when I eat fruits - too many of them - I get really hungry and often want and eat more. 

Fruits are simple carbs. Not only they are like candy to my system - but the insulin release they cause may make a person more hungry, less sensitive to the "full- empty " signals.  And fruits are "slider " foods.  

I eat fruits. To gain weight. Or maintain and stop losing.  That is reality of my life now. But even now - I limit that to berries, and grapefruit.  Berries cause the least sugar spike in my system. 

Maybe it is time then to give up oatmeal?  

 

 

Yes, I think I will probably lay off the oatmeal for awhile and rely more on my homemade protein shakes for breakfast (banana, peanut butter powder, cocoa and Almond milk). 

 

I really believe my hunger is primarily head hunger. I am eating the same way I have eaten for a year and lost 185lbs. I could be wrong, but I think the change I am experiencing has to do with psychology more than physiology. It seems to be completely tied to the change in routine. Laying around after hip surgery, taking pain medication, and having limited ability to move. 

 

Yesterday was by far the easiest day for me in weeks. For the first time in at least two weeks I didn't experience the near compulsion to eat at night which has been my achillles heel. 

 

And I dumped a bunch of weight last night (3 lbs). I have now shed 15 of the 25lbs that I picked up in the hospital - 11lbs of that over the last 4 days. And there is still quite a bit of swelling (not to mention they implanted a titanium part weighing 2-3lbs inside me). 

You rwally, really need to weigh your food and log it closely. If you did, you'd find that this menu was WAYYYY over 609 calories. Using 'a large bag- as a measurement will make you regain a lot.

A bunch of extra fruit may be psychologically better than extra ice cream, but nutritionally it isn't. It's still a big pile of sugar that will make you eat more and gain weight.

Especially healing from major surgery, it should be protein, protein, and more protein.

Oh, I do weigh and measure everything, I just posted "large bag" for brevity.  Every week I buy fruits/veggies on Sunday, and depending on the quantity I have on hand, I figure out exactly how much of each I want to have, then weigh that exact amount into each bag, so every bag is identical (literally cutting small berries up to be exact as necessary)  I realize "large" is subjective, I guess it was large to me, but based on weighing, measuring and putting everything in MFP it was 609 Calories:

 

Cucumbers: 97g - 15 calories

Tomatoes:  125g - 22 calories

Red Bell Pepper: 50g - 65 calories

Total Veggie Bag:  102 Total Calories

 

Strawberries: 3oz - 27 Calories

Blackberries: 2oz - 24 Calories

Blueberries: 3oz - 48 Calories

Rasberries: 0.6oz - 10 Calories

Total Fruit Bag:  109 Calories

 

Oatmeal: .231 Cup Uncooked - 139 Calories (I derive this by total uncooked divided by total number of portions)

Apples: .231 medium apple - 18 Calories (derived the same way - I confess to not weighing this apple but logging it as a "medium", so I could be a few calories off here)

Total Calories:  157 Calories

 

I won't bore you with the ingredient list of the Coconut Curry Chicken, but I track everything in there.

Coconut Curry Chicken: 240 Calories

 

Total Reported Food:  Veggies (102) + Fruit (109) + Oatmeal (157) + Coconut Curry Chicken (240) = 608 Calories

 

As far as the nutritional difference between fruit and ice cream, I will have to respectfully disagree.  I understand your perspective, and I know a lot of people have a view that "carbs are carbs", however based on my reading/research and my doctors guidance I don't feel that's true.  Aside from the fact that Fruits and Ice Cream are VASTLY difference in macro content, fruit is also loaded with a tremendous amount of phytonutrients that do wonders for your body.  But the most relevant part here is how your body reacts to sugar in fruit versus refined sugars (or any refined carbs) is very different.  Fruit binds the sugar with fiber, and fiber slows the absorption of sugar into your bloodstream.  This slowed absorption prevents the sugar spikes and crashes that are a given with refined sugars/carbs.  You body doesn't see a huge spike in blood sugar, so it doesn't over compensate by dumping too much insulin and driving down your blood sugar to low levels, causing you to crave more carbs.  As the blood sugar rise that results from fruit is a slow and steady one, your body can more appropriately regulate the amount of insulin and keep your blood sugar well regulated.

 

Again, I do realize that my surgeon's plan is not the same as most other surgeons.  It's one of the more challenging aspects of my post-surgery life in the fact that many of the food plans/recipes posted on bariatric sites are not necessarily things I can have.  People tend to rely on processed protein shakes/powders/bars (he uses shakes immediately post-op out of necessity but wants you off as soon as possible) where I can not have those.  People also tend to eat a lot of dairy for the protein content, I also can not have those.  People go with large portions of animal proteins, whereas I am supposed to have small portions of those with large portions of veggies.

 

I've definitely had a lot of other WLS patients over the last year challenge my food plan, but ultimately I chose this surgeon because I liked him and believed in his approach to eating "real foods" (my words, not his).  I have had a ton of success (188lbs lost in about 9-10 months, from 333 to 145), and have not struggled with hunger or food choices until these last few weeks after having hip replacement surgery.  Being back at work all day is doing WONDERS for my hunger level.  Keeping busy is a great lesson learned from this experience.  I clearly do NOT do well with a lot of time on my hands and a bunch of crappy food at my disposal.  I need to make sure I avoid that for any length of time whenever possible!!

 

 

I LOVE your surgeon.  His videos are the best and very informative.  I don't follow his plan exactly but I have amended my diet a bit after my dietitian asked me to up my carbs and actually dropped faster after i added more complex carbs and lowered unhealthy fats like cheese.  

Berries are very healthy fruits to add to your diet.  they are very high in fiber and lower in sugar than most other fruit.  they do not trigger cravings in me like others are concerned about.  I do avoid the higher sugar, lower fiber fruits.  I always laugh when people equate fruit and ice cream or other desserts.

One suggestion i have if you are feeling the need to cut down on your steel cut oats quantity is to add in chia seeds  which bulk up the mixture.  I make my overnight oats with just 2 tbs of oats, 1/2 or 1 tbs of chia seeds and 1/4 apple for flavour with some cinnamon.  I do use premier protein as my "milk" which i know is a no no in Dr. Weiner's book (being processed), but i love it in my oats or chia puddings so I let that be as that is the only processed food in my diet.  

You'll be back on track in no time.  

 

Dr. Weiner is the best.  Not only a great surgeon, but such an awesome guy.

 

For right now, I've just cut out the oats.  He basically added that in for me (and if you've watched his videos, you know that this is normally not "approved" food). due to the fact that my weight was getting so low, and I was working out on a regular basis, so he felt they were warranted.

 

I have become pretty accustomed to using Almond Milk for all my "milk" needs - but it definitely doesn't give you the protein that a premier would!

 

One of the best things about Dr. Weiner is that he is a total realist, and I try to take that same approach.  For instance, I have cut out milk completely, and do not each cheese, etc as a snack.  But if I'm eating a meal that has a small amount of cheese in it, so be it.  I probably have cheese in something 2-3 times a week, and it is in small portions.  He doesn't believe in deprivation, and does not even encourage people to stick 100% to plan.  He says if you can do 90% you will achieve amazing, sustainable results.

 

I agree with you on the fruit thing.  I have taken a lot of heat on forums and talking to others over the last year about fruit intake.  Grains is another thing.  A LOT of people can eat whole grains, and get on my case when I tell them I don't eat brown rice, whole grain pasta, etc.  People regularly tell me my doctor is insane, or doesn't know what he's talking about.  Which I find odd because they are basing that on what their doctor told them, or worse, what they found online. 

 

I think what I find strange about the intensity of people's feelings on diet is that there is no 100% solid, scientific proof of most of this.  You can find articles online to support whatever diet you want to follow, yet people so often feel their diet is the best or only true diet.  Remember when fat was bad and so we all ate a TON of carbs?  Now carbs are bad, so you can't have fruit - and fat is good as long as it's good fat?  What I do know is that Dr. Weiner's Pound of Cure diet has been amazing for ME.  I find it very easy to follow, and most importantly SUSTAINABLE.  It is not a diet of deprivation - if you're hungry (truly hungry, not this stupid head hunger I've been dealing with), then EAT.  Just eat the right things.  If I can't eat when I'm hungry, my body will fight me, and history has taught me that I will lose - EVERY SINGLE TIME in the long run.  And, I also look at the food that I eat, and (this is totally opinion and subjective) I think "how can this diet possibly NOT be good for me".  I mean I eat pretty much nothing but fruits, vegetables, lean meats, beans, lentils, etc.  I have eliminated most dairy and the majority of processed foods.  I feel great, and I have lost a ton of weight.

 

It's my head that is my enemy right now.  That, and change of schedule (and possibly medication).  Getting back to my routine has not 100% resolved my issues, but has made compliance much, much easier.  I am doing much better these last two days and am bound and determined to get these last 7-10 pounds back off - most of which I am still convinced is from water retention and swelling.

Yes...it is your head.  I'm pretty sure i remembering you posting about a month ago about how to stop losing (good problem to have).   I do have his book so know about the oats, but he does say limit.  I figure my 3 tbs a day is probably is minimal in the grand scheme and I'm losing on it, I'll elliminate them if I start to stall. 

BTW an article based on this:   http://www.bmj.com/content/352/bmj.i17 showed up in my news feed today.  It is a 23 year harvard study on flavanoids.  basically endorsed eating more fruits and vegetables high in flavanoids to control weight.   

That's a really interesting study.  One of the things I've focused on is not eating a single (or small variety) type of fruit and/or vegetable(s).  My thought (again subjective) is that they all offer different nutrient profiles, so it may serve me to eat a wider variety.

 

For fruits, I consume a lot of berries (primarily blackberries, raspberries, strawberries and blueberries) but also mix in apples, bananas, oranges (all different varieties), grapes, mangos, etc.  I am always open to try any new fruit or whatever is in season.

For veggies I eat a lot of cucumbers, peppers (prefer red bell peppers), tomatoes, sweet potatoes (regular, purple, magenta, etc), spinach, onions, broccoli, cauliflower, green beans, brussel sprouts, romaine, etc.

 

Weiner's program looks solid.  I'm a nurse, and was raised very nutritionally conscious.  I have a PTSD-type situation around vegetables, and physically cannot make myself eat them.  I'm addressing it in therapy and it's getting a little better, but I will never be able to eat the sheer volume of veggies in his plan.  I honestly wish I could, because it is nutritionally sound.

I totally agree with you about the fads and phases of the "best diet" stuff.  I cannot do a keto diet, it makes me incredibly ill.  So right off the bat I'm in conflict with most WLS surgeons and patients.  But my surgeon and I have discussed the challenges, and she's not a huge proponent of keto in the first place.  So I'm working with the plan she and I agreed on, and just trying to do my best to make better choices than I used to.  :)