1 yr out & gaining weight

I posted this on the main board but now that I have looked here this is a better place to post I think. I lost 140 pounds first six months with RNY one year ago August 31.  Then four months no loss followed by two months gaining back 25.  My doctor has me on two weeks liquid protein only.  Very hard.  I have started going to the gym again with one hour workout on tread mill and 10 minutes or so with stair stepper. After two weeks of the liquid protein I have to call my doctor (this is my surgeon) and he will tell me what I can start eating. For goal weight I need to loose 30 pounds and I am determined to get there.  It is also at goal weight he will do the TT procedure, which I am really excited about and could kick myself since I was 5 pounds from goal weight before I started putting this weight on.  I wasn't going to the gym (telling myself I am too busy with my long day work schedule) and I have a hard time eating meet or fish as it comes back up.  I had a stricture in March that showed an ulcer and then a bleeding ulcer in July.  I also have an abdominal hernia that recently showed up that he can fix when I have my TT. Any thoughts or advice would be greatly appreciated. Jim

Hi Jim, There are many reasons why people gain weight after 1 year. The most common is: stretched pouch. When you are immediately post op, your pouch (for a RNY) is approximately 30 mL, or the size of a shot glass. Over time, the pouch will slowly stretch. Usually after 1 year a person can eat 1/2 sandwich, 1 piece fruit and 8 oz beverage at one time. Very different than immediately post operative. With an increased pouch size, means increased food intake. So, my first step for you would be to take a good, honest look at your diet (prior to the liquid shake). How were your eating habits? Were you making healthy choices? Is there room for improvement in your diet? *** If you post your usual daily intake (not the liquid diet) I can take a look and let you know if I have recommendations **** The second step would be to evaluate your exercise habits. Which it sounds like you've done. You want to get yourself into a manageable routine. Do some form of exercise that you like to do and that you would ENJOY doing 5 days per week. Right now you are doing 70 minutes of exercise, that's great, but is it realistic? I don't want to see you lose this 30 lbs, get the tummy tuck, and then ditch the 70 minutes of exercise. Guess what will happen .... ??? Weight may come back again. But, if you do an exercise that you enjoy doing, the weight may come off a bit slower, but, once it does, you can maintain that exercise level and keep it off. The ULTIMATE goal is not a numbers goal (getting the scale to show you a certain number) - it's keeping the weight off. Having the TT alone will allow for increased weight loss. You are probably carrying around some heavy skin. In addition, you don't have to eat meat or fish to be healthy, you can do it without. But, go ahead and post a few things for me so I can help you a bit more: 1. Tell me your usual intake of food 2. Is exercising 70 minutes per day realistic for you? 3. What is your current height and weight? I can help more with the above information. Thanks! Sara Nejat-Bina, RD eNutritioncare.com Sara Nejat-Bina, RD eNutritionCare.com

Thanks for getting back to me.  My bariatric surgeon has me on three protein shakes a day and will soon go to one morning one for dinner and a salad for lunch. I did say one hour on the treadmill but that is a mistake.  I have been going to the gym on my lunch hour at work for  a 15 minute mile on the treadmill and most days after work I have been doing the same, along with 10 minutes or so on the stair stepper.  I do  hope to work up to 1/2 after work (2 miles) very soon.  I would like to do this six days a week and still go to the gym at lunch at least 4 days a week. As far as what I have been eating, well, truth be told I have not been eating right.  I often cannot keep fish or chicken down.  Seems like it get packs in my pouch and comes back up.  I have mainly been eating soft foods like low fat yogurt, baked beans, almost any kind of beans, mash potatoes, baked potatoes, and chili.  I did have a sticture about three months ago that a doctor opened up.  I also told myself I could not find time to go to the gym, which was a real mistake. So here I am.  Ready to change. As I mentioned, my doctor had me on just protein shakes and yesterday told me to go to one morning, one night, and a salad for lunch.  He did not mention what kind of salad or dressing so I have to figre that part out.  Then, once I loose the weight, I have to figure out what I should be eating and keep up the exercise. Any suggestions would be appreciated.  I really do want to loose the last 25 pounds as well as have the TT procedure.  Plus getting the adominal hernia fixed. Regards, Jim