plateau

 I am almost 8 mo post op. I had my lap RNY in march. I have been on the same 2-3 lbs for the past 3 wks. Is this normal? Could you give me a ball park around how many calories I should be consuming? I know protein should be atleast 60. Let me know. maybe I am consuming to much. 

Yep, perfectly normal.  I hit a plateau around the 8-9 month mark that lasted nearly 8 weeks.  But the scale is moving steadily again and I'm back to losing. 

Technically you are not in a stall or plateau until you have not lost any pounds OR inches for a full 4 weeks.  Have you taken your measurements lately to see if you're losing inches?  Around the 8 month mark I was taking in around 1000-1200 calories per day whi*****luded about 100g protein.  I get about 30g protein per day from my morning protein shake and get the remaining 70g from food. 

Here's a list of question to ask yourself to make sure you're on track and doing everything right. 

From my blog:
http://pamtremble.blogspot.com/2008/09/breaking-stall.html

• Are you tracking your food intake in a food journal? Is it on track?
• Are you tracking every single calorie that passed your lips? (flavored water, vitamins, gum, single pieces of candy) Even if you aren't keeping track of calories, your body is!
• Are you eating too MANY calories?
• Are you eating too FEW calories?
• Are you taking in enough protein? 80-100g/day
• Are the fats you're eating healthy (polyunsaturated and monounsaturated)
• Are you eating too many simple carbs (bread, pasta, potatoes, sugar, pasta, rice)
• Are you eating enough fruits and veggies?
• Are you drinking enough water (water flushes fat toxins from our body)?
• Are you grazing?
• Are you eating the right quantity? Measuring and weighting foods?
• Are you eating on a schedule?
• Are you exercising hard enough? Long enough? Fast enough?
• When's the last time you changed your exercise routine? (The body becomes efficient and doesn't burn as many calories after we've done the same thing for 4-6 weeks)
• Have you added weight training to your workouts? (muscle burns more calories at rest)
• Are you taking all your vitamins and supplements?
• Have you started taking any new medications that might promote weight gain?
• Have you taken your measurements (you might be losing inches even if the scale isn't moving)

Also, here's a great post by DxE that has a ton of information that might trigger ideas in some other areas to break a plateau.

     Hi Pam,
I have noticed many times that you have such an inspiring answer to people's questions; I am now about 6 months out(the 6th)and am only at 85 pounds or so.I say"only" because my surgeon at 52 pounds lost was not happy with me.He said I should have been at 70.I cried for weeks after that,because at 6 weeks I was hospitalized for an ulcer,a stricture,malnourishment,and dehydration.They fed me through my veins TPN for 11 days.I figured he would take that into consideration,but he didn't.Now I am terrified of seeing him again! I have joined curves now,and am working out 3 times a week.My energy levels are still not where I want them,but I a trying.I do get my water in,and try to get the protein.Do you have any advice for me? I haven't seemed to lose in the past 3 weeks since I started curves...but maybe when they measure me on the 10th I will have lost inches.Thanks Pam,and I think you are AWESOME!!!  Miss Paula

First of all... Shame on your Doctor!  How dare he criticize you for not losing enough weight by a certain point.  Of any doctor out there, a WLS surgeon should know that losing weight is not something that happens automatically and on anyone's time table.  Next time he pulls that on you ... tell him exactly where he can put his mean words!!

Ok... so 82 pounds in 6 months.  Let's look at the averages, first.  It is generally anticipated that after WLS people will lose about 20 pounds in the first month and about 10 pounds per month after that until you reach about 6 months when things can slow down for some people.  So in 6 months that means the average person would be down 70 pounds.  You've already lost 82 pounds so you are WAY ahead of the game and doing an outstanding job!!!  WooHoo!!

Ok, so let's talk about your energy level.  Here are some things that might be contributing to fatigue or low energy:

* Not eating enough calories based on your activity level.
* Not eating enough protein.
* Low blood iron levels (anemia)
* Low B12 (or any B Vitamin) level.

I assume since you're approaching your 6-month mark that you'll have labs drawn in the next coule weeks.  Make sure you get a copy of the full lab report so you can study the results and see if there is anything that needs attention.  Come here and tell us what your levels are if you don't understand something.  

How much protein are you eating each day?  You say you "try to get the protein" ..... as my childhood pastor used to say:  "There is no try, there is only DO."  You're either getting in your protein or you're not.  Be absolutely honest with yourself and figure out what you need to do to make this happen.  You need at the bare minimum 60g per day.  80g would be much better.  I have found that my energy level is at it's best when I'm getting 100g per day. 

If you aren't eating enough calories you could see a major slow down or stop in the scale and your energy level will tank.  So take a close look at what you're taking in and make sure it's a balance level with enough calories.  AT 6 months I was doing around 1000-1200 per day. 

Good for you joining Curves!  Keep up the good work on that.  Maybe increase your visits to 4x per week to get that scale moving again.

Hope this helps,
Pam

  God Bless You Pam!!!! I have had my labs done this month by my PCP...My iron level is low,and my b-12 is low,so I am now on 4 vitamins and an injection of b-12 monthly.If I decided not to go back to my surgeon,what would happen with having plastic surgery for the excess skin????Do they not have to refer you???Thank you so much for the info.It helps to know that hey-maybe I am doing something right after all!!!!!!********((((((((((hugs))))))))))) Miss Paula

Does your surgeon have other people on staff to help with your after care?  Nutritionist?  Support Groups?  Psychologist?  If so... then I'd keep going to see your surgeon for follow up visits, just so you can stay connected to the other programs he has.  Also your surgeon is going to be your best contact to help identify and treat complications related to your surgery -- bowel obstructions and vitamin deficiencies, etc.

You don't need your surgeon for a referral to your plastics consult.  Your PCP would probably do that anyway. 

Pam

  Thanks for the advice again Pam....yes there is a nut and a psychologist in the same office; I will keep going...grin and bear it!!!!   Thanks!!!