MOST EFFECTIVE LONGTERM POST WLS DIET - Ketogenic vs "Freestylin'"

my surgeon recommends high protein, high fat and very low carbs.

I lost 122# and have maintained the loss for 8 years with NO exercise and all my organs are in fine shape.

I agree with your surgeon and am 16 years out. I have gained 40 lbs after a surgical procedure and menopause :( Using the above formula to lose the regain. I am tracking and I was wondering what are your macro's of protein, fat and carbs? I am not sure i am low enough in carbs and high enough in protein. Would you mind sharing? thank you

Hedy W.

80-100 gas of protein and the least amt of carbs possible.

When I'm losing phase, I try to keep carbs 20 or less.

Mom regular maintenance, I try to stay around 50.

I don't know many bariatric programs that recommend this -- in fact, most completely the opposite.

I find this to be a FALSE statement.

I eat a very low carb/high protein/moderate fat diet -- lost 220 pounds and maintain a 20.5 BMI. I am 4 years out.

How close are you to what you consider your ideal weight ?

I'm within 10 lbs of my preferred weight. I won't use goal or ideal-- cause it's neither of those. But is a number I'm more than willing to live with and need to work at to maintain.

Do you have to exercise to stay there?

I'm not sure- I assume yes. I've never not exercised during this journey so I have no comparison. But since I plan on keeping my routine it's a moot point. I do not eat low fat, but since I exercise I do not worry about it. I do not subscribe to any particular diet- I do what works for me.

Do you feel free from "food pressure" or would you eat more if you could ?

I would eat more bad stuff if I could. I have no interest or desire to eat more of the WLS friendly stuff (.ie. larger protein servings)

Have you had health problems since surgery like RH or appendicitis ?

Ive has bouts of RH, but have been able to fairly easily ideanity wht foods cause it. Otherwise, no problems.

I eat high fat, low carb - but not keto. I do not eat low-fat anything. At least daily I eat 2+ TBSP of heavy cream, 1 cup of whole fat Greek yogurt, 1/2-1oz of nuts, full-fat cheese.

How close are you to what you consider your ideal weight?

"They" say that my ideal weight is 147. I currently weigh 125-128.

Do you have to exercise to stay there?

I love to exercise, so before my plastics I was working out 3-4 times per week. It's been 4 weeks since my plastic surgery and I've barely moved a muscle but haven't gained.

Do you feel free from "food pressure" or would you eat more if you could?

We all have eating issues. I would ALL THE BAD THINGS if I could. But, I know I can't. I do not feel starving or deprived of food. I eat 1,700-2,300 net calories per day. Right now I'm eating at the lower end of that because I'm not working out.

Have you had health problems since surgery like RH or appendicitis?

I haven't had any health problems.

I'm not very far out, but I've been in maintenance for over a year. I'm at my goal weight. I do exercise moderately c. three times a week, but I"m not a gym rat.

My bariatric clinic's program was high protein/moderately low carb. They never said anything about fat.

During the weight loss phase, I aimed for 100+ grams of protein, and c. 80 or under grams of "good" carbs. I did not eat sugar or white carbs.

now in maintenance, I still aim for 100+ grams of protein a day (I malabsorb it, so I have to). I average 1500 kcal/day. I still rarely eat sugar or white carbs, but I do often get 100-150 grams of good carbs in a day - but then, I'm not particularly carb sensitive (I know a lot of people *are*, and if I was, I'd shoot for lower than that). I've recently started adding more fat to my diet to keep me feeling satisfied longer. Protein, fiber, and fat all help - but of the three, fat is the most effective - at least for me. I know fat is very caloric, but I just work the extra calories into my 1500 kcal/day goal.

Thanks for your thoughtful replies .. VERY interesting and thought-provoking.

I'm beginning to see a pattern of what works ( I Think) ... and everyone's preferred menus CAN work .. that's the good news :)

Writing it all down so it makes sense .. oy

How close are you to what you consider your ideal weight?

I'm at my ideal weight. 5'8" male at about 152lbs give or take. I'm just short of 2-years post-op and have been in maintenance for about 14.5 months.

Do you have to exercise to stay there?

No. I try and exercise for my health, but not for my weight. I find very little correlation actually. I'm pretty good about exercising on a regular basis (at least walking the dog a few times a week), but I have been really bad about it this winter. It's been extremely cold and snowy here, and I've let that be my excuse instead of toughing it out. Time to get back to it as things thaw.

Do you feel free from "food pressure" or would you eat more if you could?

I am feeling more and more free as time goes by. I adhere to my diet pretty strictly, but it doesn't feel like a limitation as I love how I eat and the food I get to eat. Sometimes I eat more than I should (but of the "right" food), but if I see the scale go up a couple of pounds, I just become more rigorous on frequency/portions. I eat mostly "whole food". I prioritize fruits, veggies and non-animal protein. I eat meat, but usually only about once a day and in small portions (2 oz or so). I do eat eggs quite frequently. I limit dairy, but do eat one greek yogurt a day for the calcium and probiotics. I also will use cheese sparingly in various recipes. I never tracked my fat intake, but most of my fat comes from nuts or small amounts of olive or coconut oil in cooking as well as the small portions of meat I eat. I avoid sugar, bread, pasta and rice like the plague. I also try and avoid highly processed food as much as possible.

Have you had health problems since surgery like RH or appendicitis?

I've had a few issues. I have RH if I eat sugar (which I virtually never do, but if I've had a couple of incidents while out to eat where I was unknowingly served high sugar food), but it is easily avoided and never have it if I prepare my own food, which I almost always do. I also had an emergency situation where my intestines got twisted up requiring surgery, and I was recently diagnosed with a bleeding peptic ulcer. I consider these all very small prices to pay, and all are avoidable or curable going forward.

The list of "free" foods on WW includes pretty much all kinds of fresh fruit. Very few successful post-ops eat unlimited amounts of fruit.

And please, PLEASE provide some medical research to back up your claim about the body refilling empty fat cells? You spout that a lot but I have yet to hear any science behind it.

Clearly, ALL bariatric surgeons don't recommend the same eating regimens -- either to lose weight or to maintain weight loss. I say "clearly" because neither my surgeon nor his nurse practitioner nor his nutritionist nor anyone else on his team recommends (and certainly doesn't "require") a keto, low-carb regimen for WLS patients during weight loss or maintenance.

Every few months I feel compelled to throw down here that I eat from all the food groups. I'm in my fourth year at this point and regularly eat eight servings of veggies and fruits daily, around 100 grams of protein (both animal and plant) daily, and don't shy away from whole grains. I also have some treat foods daily, but do not overdo them. Most of my daily calories (1800/day) come from quite nutritious foods.

FYI, I'm 72 years old and have lost 100+ pounds and kept it all off. I'm fortunate not to have any diseases or illnesses (that I know about) other than a little hypothyroidism for which I take a daily levothyroxin pill.

I also weigh daily, exercise 5-6 days a week, and take my recommended supplements daily.

I'm not recommending that all WLS'ers do what I'm doing. I'm merely saying that this "all food groups" regimen works great for me. I'll also admit that I'm the WLS patient about whose success I care most. :)