When to Increase Calorie intake?

I am 12 weeks out from my VSG. I was doing fine on about 600 calories per day and losing slowly but consistently (down 39 lbs) up until this past week. 600 calories is just not keeping me full any longer. I am still eating almost exclusively protein, but find I am hungry between meals now and by dinner time, I am ravenous. My next appointment with my nutritionist is not until mid March, so I am wondering if I should increase my calories to 800-900 at this point. I don't want to stop losing, but I am worried because my appetite is BACK!

Typical day:

B: 1 egg with 1 oz meat and 1 oz cheese (or guac).

Sx2: 1 oz chicken or pork jerky or half container Oikos triple zero

L: 3 oz protein like grilled chicken - or - tuna salad w/parmesan crisps - or - 3 oz tilapia filet

D: Depends on what I am making for the family, modified for my diet.

E: Walking 8,000-10,000 steps or treadmill with some weights.

I wouldn't increase calories. Not until I was done losing. What you are experiencing is either head hunger, or increased acid. Acid mimics hunger. Many people have to adjust PPI dosage, or switch types, to keep the acid at bay.

Never had an acid problem, either before or after surgery, so not on any meds. I'm guessing it's my increased activity, or as you said, head hunger. Just wanted to make sure I am taking in the right amount of calories.

VSGers are almost universally put on PPIs immediately after surgery. Acid is an extremely common side effect. About 25% of VSGers eventually develop reflux. I strongly suggest you talk to your doc about going on a prescription acid reducer.

Most people have problems with acid post-op, because it takes a while for your stomach to realize it doesn't need to produce the amount of acid it was used to producing. Just because you didn't experience this pre-op doesn't mean it's not what's going on now. Taking a PPI (or even an H2 blocker like Pepcid) is an easy way to find out if your hunger is due to increased acid.

Of course, if you just want to suffer through the hunger, that's okay too!

how much liquid are you drinking. 64+ ounces every day?

dehydration mimics hunger.

I am getting all my fluids and then some. I thought perhaps it was because I have been increasing my activity steadily over the past few weeks; more time at the YMCA, walking and general moving.

I agree with Grimm. If you aren't taking a PPI such as Prilosec or Nexium, try taking one for a week and see how it impacts your feelings of hunger. (Or take a stronger one if you're currently taking one.)

In addition, work on switching to denser proteins where you're currently eating lighter proteins. (I.e., swap in steak for yogurt.)

My dietician recommended that I be between 600-800 calories per day right now. Most days I'm over 700, and I'm stil losing consistently. That's just me personally, but I feel comfortable with it.

My dietician and surgeon also recommended 600-800 calories, provided I was getting my 64 oz. of calorie/caffeine free fluids. On the 6th, after my next appointment, my sheet says 700-900 calories (which is the standard with their plan until I hit maintenance.) There aren't any instructions after maintenance (which will be at least another full year for me anyway) but I'm guessing I'll have to do some guess and check with that.

I've been losing pretty consistently, so I'm happy. As long as I keep losing at least 15 pounds a month, I'm going to stick with the plan they give me, because I don't like eating less than 600 calories. Now, if I suddenly stop losing for more than a week or two, I'll decrease and check it out.

I will say that my labs looked phenomenal. My doctor ordered me to stop taking the B complex, because all my B vitamins were off the chart. They have this cool app where I can download them and file them, too, so I can keep track of it myself.

Woo...started rambling. Sorry!