I'm tired all the time and it's probably because of my diet. What do you eat? How much do...

Three years ago I had a gastric sleeve and one year ago I had the duodenal switch revision. I started at 454 pounds and currently hover around 200. It's a significant loss, I know, but I don't feel great. Actually, I feel kind of terrible. Most days I'm lethargic and there have been days where I can sleep for 16 hours. Just being awake exhausts me. And it's not the type of sleepiness you feel when you wake up in the morning and want "five more minutes" it's a fatigue that I can feel in my entire body. Just getting out of bed takes so much physical effort. I didn't feel this way after the sleeve, it's only been a problem following the duodenal switch. My labs all show everything is normal, so I think it's my admittedly, shamefully terrible diet. 

I know I don't get enough protein. I eat way too much sugar. I've turned into a grazer, eating the wrong things every two hours. I rely too much on fast food and have a crippling candy addiction. There's a vending machine at work and every day, I'll get at least one candy bar. Some days more. Once, I had forgotten my wallet at home and went the entire day without any type of candy or sugar and I had the worst headache of my entire life. My boss thought I was sick because I probably looked as awful as I felt. 

But I don't know what I should be eating. My surgeon's team includes a nutritionist who is very smart and very nice but doesn't offer much guidance beyond "getting your protein in." I'm a terrible cook, everything comes out bland. So I end up walking over to McDonald's (yes, I live within walking distance of a McDonald's sigh) and getting a #1. And I can eat all of it. Which is crazy because three years ago I couldn't even think about trying to eat that. Now I'll eat the Big Mac and the fries and two hours later eat candy. I feel like I'm worse now than I was at my heaviest.

I want to fix it. But I don't know where to start. What do you buy at the grocery store? What are your favorite recipes? Do you meal prep? What do you do when you're craving something sweet? Do you ever feel...not satiated after eating a meal? Do I just have insane head hunger? I know I'm all over the place but I don't really have anyone to talk to about this. 

i think you are in a perpetual "carb coma", all the time and that is why you are tired. Also carbs and sugar can upset my stomach and make me feel bad. 

The only advice I have for you to go cold turkey on the carbs. I bet you feel better after the first few days detox. That is what the headache was from, carb detox.

Protein foods:  Jerky 12g protein per oz, nuts, salami, cheese, deli meat, hot dogs, steak, pork chops, chicken, fish, peanut butter (just need a spoon to eat it out of the jar- no bread needed).

Get a little ice bag, chest, container and take it to work with you.  Load it up in the morning with protein.  Eat protein every hour or two.

Have you had your labs done?  Are you taking your vitamins? 

Do you have a crockpot?  Put a roast, chicken, pork... whatever, put some liquid and herbs to taste and let cook all day.  You now have several meals to take with you.

Get some protein bars (20-30g each) and eat them instead of a candy bar.  I like the Cliff bars 20g, 18pk at Sams $20.  9 peanut butter covered with chocolate and 9 mint chocolate.  Premier protein bars or shakes are 30g each. 

Lots of good ideas, thank you! Definitely need to get a protein bar, I don't know why I didn't think of that.

I have had my labs done, everything always comes back normal. My vitamin D was a little on the low side so I take a little more now.

I think you already know the answer, maybe not the details of what to eat but that your diet is the cause of your feeling poorly, and that you won't feel better until your diet changes. Surely you know what foods constitute protein - meats of all kinds, eggs, fish, shellfish, cheese, nuts, etc. You can find tons of recipes  on the internet - just search for low carb or paleo, or for a type of protein you like, such as "chicken recipes" and you'll find many. If your cooking is bland, these recipes where other people have figured out what spices to use should at least get you started. Look for recipes that make extra so you can take leftovers to work - hopefully there is a refrigerator and microwave you can use. You won't feel well until you get in your protein.

You mention that your labs are ok. what labs? Most docs have no idea what labs someone with the DS needs, including many bariatric surgeons, given our degree of malabsorption. Did they check albumin and total protein? The fat soluble vitamins (A, D, and k)? Zinc? Copper? B vitamins?

And if none of that helps, consider the possibility that your fatigue is not related to the DS. granted, it started after your DS, but that isn't proof. We can get any medical problem anyone else can have, not just problems caused by the DS. If your protein levels and other labs are good and your diet is good and you still feel like crap, contact your pcp and get a proper work-up.

Larra

To be completely honest with you, I don't know what labs they take. The PA just says "everything came back normal" and I leave it at that. I know that sounds awful, I know I should be asking questions. And you're right, I do know the answer, I guess I just feel alone, which is why I came to this board. My friends and family don't struggle with weight. I have a colleague who had traditional gastric bypass but I know no DSers in person. I'll get a copy of my labs. Are there guidelines for where I should be?

Sugar and carbs are not the answer.

I have almost the exact same issue with fatigue, sleeping and eating lots of sugar. It was really bad the past few months but not as bad the past couple of weeks.

I still eat a lot of treats but cut back a bit on the carbs overall. I'm also getting more exercise now which seems to help. My labs are always good as per my DS surgeon, but I was told by a dr in the UK while traveling that I have a fluid buildup in my abdomen. He was concerned about, my DS surgeon at home was not. During that time was the worst part of my fatigue stretch. It seems to have calmed down after a couple of months. I'm going to a nephrology specialist in a couple of weeks to be certain.

You mentioned you were lonely and described you eat protein and not sugar.  Regardless of what surgery you have, that's basically a formula for fatigue and ill health.  It also may be a sign of depression, your fatigue.  Also, carbs stimulate insulin production and insulin stimulates hunger, whether or not we have reduced ghrelin.  McDonalds basically is also designed to be addictive intentionally; Kessler wrote a fantastic book about that.

I would actually suggest seeing a counselor.  It sounds like you do not have very much support, and surgery alone won't fix behavior-motivated eating.  I still see my own counselor even though I am one myself.

As for getting protein in, what do you like to eat?  I spend a little more to eat better food I enjoy which means I don't cheat as much.  I hate chicken for the most part and only like beef.  I bought better spices and everything tastes better.

Getting plenty of protein should be your priority.  Most McDonald's meals are filled with carbs.  The tiredness could be from a number of things, but protein deficiency comes to mind.  How is your iron?  Are you getting full DS labs or the standard labs from your regular doctor?  

Many of the ideas others have presented are similar to what I do - crock pot meals, protein snacks, etc.  If you can eat a lot (as indicated), try switching what you eat for fullness.  There was a point where protein was no longer enough for me.  Rather than filling out my meals with bread-like carbs, someone suggested to add veggies and fruits back.  It did seem to help make me fuller.