Confused.

Hi. Twenty years ago I had the Gastric Bypass. I had a revision of the Duodenal Switch back in January of 2020. I started losing weight quickly and went through my first stall in my 4 and 5th month. As of my ninth month, I have lost 82 pounds. I didn't know ObesityHelp was around, so this might help me with a lot of the questions I have. But prior to finding Obesity Help, I got my information on the various bariatric surgery boards on Facebook.

I have a lot of questions. My surgeon and dietician haven't told me much even when I ask them. My dietician said only 60 grams of protein and at most, 1300 calories a day. When I did that I stopped losing weight all throughout my stall. So, I started paying attention to the people on the bariatric boards on Facebook. They would tell me at least 120 grams of protein and 1500 to 1600 calories a day. I started losing a little weight, maybe one to two pounds a week. But I'm told that is very little.

ALSO, I have terrible constipation. Even with all the walking, exercising ( I ride my recumbent bike 6 to 7 miles a day), tons of water, eating fruit and taking Miralax. So, I asked the people of Facebook and they said I'm not eating enough fat. A couple of people told me I should know better. Well, I'm getting information from different sides and I'm very confused. I know I should be losing more weight. And I should be able to use the bathroom (I mean, my stomach makes all the right noises but I can't go).

So, PLEASE. What should I do to help myself?

As you have already learned, people on Facebook groups are notorious for spreading misinformation. With DS you don't absorb fat, but you do absorb every carb that you eat. Eating more calories is not the way to lose weight.

One or two pounds a week is excellent weight loss after nine months. You need to deal with the constipation. I would suggest you follow your nutritionist advice, but ask for guidance with the constipation.

Fruit is sugar. All carbohydrates should be the LAST thing you eat. This is how we lose weight and maintain the loss. We avoid carbs and sugar. If you want to know how to eat to lose weight read Atkins induction diet and add more protein. The only carbs you need to be eating right now are low carb veggies like green beans, spinach, and salad type greens. Brussels sprouts. Cabbage.

Constipation. Eat a lot more fat. Use butter, cream, and real mayo. Add fiber. If you need to, take psyllium capsules. If you take psyllium, keep up with the water! Psyllium is an indigestible carbohydrate so it doesn't count as a carb!

Protein. A LOT of us don't need 120gr per day. Some do. I would be happy with around 100 and adjust upwards according to your labs which are coming up in January, right? For more than a decade I stayed around 100 but now I only need about 80. Your needs will change over time. When you need to adjust, you change things. A general rule is to always eat protein first. Always. Next, fat, and LAST, carbs. I don't count calories at all. If I eat this way, I don't need to!

Don't drink calories/sugar. No juice. If you have to have fruit, EAT the Fruit. NOT JUICE. Me personally, I probably don't eat more than 10 or 20 bites of fruit per year. And I would bet I haven't even tasted juice in more than a decade.

Weightloss. I think you are doing well. 1 or 2 pounds a week for a revision is VERY good. Here is a tip. Almost everyone has some weight gain. When you hit your goal, lose 10% more so you have some wiggle room. So if your goal is 140, lose 14lbs MORE.

Maintenance. Once you hit your goal you may be able to eat more carbs without gaining. Time will tell. The best maintenance plan I have ever seen came from someone here years ago. She weighs every morning. If she is over her goal weight 3 days in a row, she goes back to cutting carbs until it is gone. Lather, rinse, repeat. For most of us, it is not effortless.

I didn't get a great DS so I live low carb. I also know I can't tolerate neverending deprivation. So I give myself cheat days when I eat nothing healthy. Holidays and vacations out of town are cheat days. This means I can participate in the holidays and I always have something to look forward to. This makes it possible for me to eat right most of the time. You need to find what works for you.

Best of luck!

You are not following a DS diet at all. You're on a "diet" and that simply doesn't work.

Yes you need full fat, which IMHO is why you're constipated.

No fruit - too high in carbohydrates.

You should be eating at least 100 grams of protein per day. You need lots of water. At goal you should be eating approximately 3000 calories per day if you want to count calories - I haven't look at a calorie counter in 18 years! The only numbers you should look at are protein content and carb content - IMHO.

A revision is a little different - generally people don't lose as much after a revision but you're doing really well with your weight loss. Just need a jump start.

Read labels - learn exactly what you're eating. No diet food - low fat = high sugar = high carbs = 100% absorption. We absorb 100% of sugar but only about 50% of fat.

you have received great advice. The only two things I would add are: many of us can't lose weight unless we eat 600-800 calories a day only. No rice, sweet potatoes, oatmeal, wheat or white flour products at all. No protein bars which are really glorified candy bars, no wine , beer or alcohol. No fruit.

the second thing is stay away from Facebook wls forums. They totally don't l ow what they are talking about. Stay here. There are many vets who have lost their excess weight and have kept it off. Follow their examples.

600-800 calories/day?

yes.

I thought most DS'ers could eat more due to malabsorption?

some can and some can't. It also depends on the foods being eAten. Carbs are still absorbed 100% so there can still be gain or at the most no loss, if many well absorbed calories are consumed.

Everyone's experience is different so I'm only adding this as some counter perspective. I eat way more food than this including a ton of fruit. My lowest weight is always in the Summer from eating 20lbs+ of fruit every week(peaches, mangos, bananas). I'm a big believer in lots of protein and fiber. Also the doctor told me long ago an egg a day keeps the constipation away. I don't know if this is true but I do eat a lot of eggs, fruit and protein. Never an issue with constipation.

I always weigh less from eating more, but heavy fruit and protein.