Not Losing

I met with my dietitian last week I have list 42.2 lbs and cannot seem to lose more I explained to he that sometimes I eat Cottage Cheese/Tomato for lunch but most of the time I eat no breakfast by the way I had lap Band Surgery on November 16, 2006.  Then at supper I have Chili and Chesse and a few crackers and a piece of cheese here and there.  My body compostion is as follows: Body Type:  Standard Gender: Female Age:  41 Weight:  249.5 BMI:  39.1 BMR:  7139 Kj             1706k cal She said I was not eating enough that I need to eat 1706 Calories a day to lose weight.  I should get 70 Grams Protein, 25 Gms Fat, 100 Gms Carb a day.  It ia ao hard to watch all three.  Is the fat as inportant as the carbs and protein.  I thought we were really trying to follow Low Carb High Protein diet.  I order a calculator that has food nutritional total I am not much on writing anything down and I thought this could help.  Please Help I am getting very aggravated.  I have 3.61/2CC in my band and it is a 4cc band.  It seems like my metabolism must be dead.

Hummm ... First of all, is the dietitian you are seeing a part of your surgeon's office? My initial suggestion to you is to EAT BREAKFAST! When you sleep at night, your metabolism "sleeps" too - when you eat breakfast in the morning, you are giving your metabolism a "jump start". So, it is important you eat breakfast everyday. Cottage cheese & fruit is a great breakfast. You want your portion sizes to be approximately 1/3 of a cup of food for each meal. You're right, you do want to concentrate on the protein - I would recommend less carbs and fat than your dietitian did, but we all have our opinions. At lunch, try to keep your portion to 1/3 cup of food - no matter what you eat. Same with dinner. Avoid high fat, fast foods - I don't know the exact nutritional content of chili and cheese, but, I wouldn't recommend it. I would recommend a lean meat, some beans, maybe cheese, vegetables - of course, all within the 1/3 cup portion size. 1700 calories seems like a lot for someone with a lap band. My advise is to stop counting calories & jus****ch your portion contol -- remember 1/3 cup of food for each meal - 3 meals per day & a small snack at bedtime. In addition - what are you doing for exercise? It's important to get 30 mins per day of exercise in as well. Hope that helps. Let me know... Sara Nejat-Bina, RD enutritioncare.com

It is the dietitian were I had my surgery!  and I was jsut eating Cottage Cheese and Tomatoes for Lunch ans they said I was getting enough nutrients and I don't eat at fast food because I cannot eat anything there except salads which does not fill me up .   If I eat any bread I get sick or Fries so it is very hard for me to eat out at fast foods.    Do you work with lap band patients?

I work with Lap Band patients, but RNY is my speciality.

I am happy you said that....I am a RNY patient, and I need some serious help. My physician's office does not have a nutrtionist at present, so I am basically flying by the seat of my pants.  I had the RNY in June 07. I previously had a VGB in 1986 and lost 200 pounds;kept it off for 18 years. Then, the band eroded and the weight came back. Bummer. So, I had a revision to RNY approx 3 months ago. I initially lost about 30 pounds within the first month, since then nothing. I have been following a strict lean protein diet, decided not to eat any carbs in an effort to break (what I hope is) a plateu.  I need suggestions on what to each, and how much. I have told my physician several times that I do not get a full feeling when I eat, I never have since I had this surgery. So it is hard to know what to eat. I am controlling it by sheer willpower but that means I walk around hungry/unsatisfied most of the time. Are there any "filler foods", such as salad, that I can eat or order to get a feeling of saiety? I have been eating nothing but egg whites, deli meats (fat free or low fat), string cheese, salsa, and chicken breast (boneless skinless grilled). I drink Atkins low-carb protein shakes which the doc told me to stop drinking and eat food instead.I dont think he understands my struggle not to overeat. This is not the way it was the first time around. Then, I could eat only a couple of bites and I was full. This time, nothing. It is as if I didnt have the surgery at all. I would really appreciate any suggestions you could give me. I do Curves every morning and walk on the treadmill in the evening when I get a chance.Thank you.

Hi! Well, I must first say that it is unusual that you would have only lost weight in the first month. It is uncommon that you would plateu so early. Typically, I tell my patients NOT to diet on top of the RNY and to just eat a "healthy" diet. The sheer decreased volume of food typically allows for adequate weight loss. Your situation is unusual. Being that you did lose with the VBG tells me that this surgery SHOULD work for you. However, you never know. If your surgeon is approachable, you may consider asking him or her to double check the size of your pouch or to be sure there is no other connections with your pouch. Usually a simple 'Upper G.I.' eval can determine this. OR, it could just be your diet. Here is the diet I give my post op patients. They usually eat similiar to this for the first 6 months (or so they tell me ... ). *********************************************** Breakfast: 1 egg 1 oz of cheese (avoid adding salt if possible) 1 cup Fruited Yogurt (no sugar added!) Mid-Morning Snack: 4 low salt crackers with 2 tbsp creamy peanut butter 4 oz non fat milk or protein shake Lunch: 2 oz roast beef on 1 slice of toast with mustard & tomato 1 cup high protein soup (recipe at end) Mid-Afternoon Snack: ½ cup cottage cheese 4 oz non fat milk or protein shake Dinner: 2 oz baked chicken ½ cup pinto beans with salsa 1 cup no sugar chocolate pudding Evening Snack: 4 oz non fat milk or protein shake ¼ cup cashews *********************************************** My High Protein Soup: 17 g protein per cup 1 cup broth (chicken, beef, vegetable) 1 jar (3 ½ oz) infant pureed meat Prepare broth from bouillon or beef base, according to instructions. Add pureed meat to broth. Stir well. Heat until soup reaches desired temperature. Ground seasonings can be added to suit taste and to provide variety in flavoring. **************************************************************** Let me know if that helps. :) Good luck. Sara Nejat-Bina, RD eNutritionCare.com