Post Bariatric WLS ? Started with High BMI and now stalled...

So here's my update.  Lost 175 lbs since February 2008.  145 since April 2008.  Done pretty well but have basically been stuck at 285 for nearly 2 months.  All the other crap is gone and except for the weight, the health is great.  Called the Dr.s office and got the usual BS, the weightloss will slow at around 8 months, probably in a plateau, just stay the course.  Not what I want to hear. 

I have been eating right, kicking ass with the exercise and watching my intake like a hawk.  Averaging around 1400-1500 gross intake cals a day.  Good protein intake at 120+ grams a day.  Keeping fat and carbs to 30-40g and 150g or less respectively.  Finally went to see a nutritionist.  Got my BMR tested and it came back an astounding 2610 cals a day. 

SOOOO, here's my dillemma.  I was told, I have to eat  more, no less than 1800 cals a  day and do  not let net cals fall below 1000-1300 depending on exercise.  Currently I a burning 600-1200 cals a days on exercise.  As BMR falls, I'll have to kick  up the exercise more or eat less.  The other stuff was no surprise.  Vary the exercise regimen and kick up the water.  Oh, and eat more veggies (hate em). 

After months of watching what I eat, I have to eat more.  So just frack with my mind why dont ya.  She also said that I am likely losing much of the malnutrition benefit the surgery provided and am entering the  really tough phase of the weight loss program.  Most folks reach there goal by the time  this happens but because I started at such a high weight (462), I am losing the benefit at at a weight where most folks would be starting there journey.  I know I'll be carrying around an extra 20 or so lbs of skin.  If I am to get to my goal, I need to lose another 70-80 lbs.  Man this is gonna be tough.  Its too early to think revision.  Really looking forward to my 1 yr checkup.  Interested in seeing what the WL doc says.  For now, will stay the course and try to follow most off what the nutritionist said.  Will try to increase my cals some.  Can probably get the extra 300 cals with a milk based  protein shake.  We'll see. 

What do you guys think of all this??  Is this a line of bull or does it sound right?

Dalton

Did you say 150g CARBS?

Yes, 150g carbs (avg between 100-150g per day) with around 15-20g fiber.   Is that too much?

I'm not a medical professional but 150g in carbs would put me back in my 28's in a few weeks! WOW. There is a new Bariatric Pyramid in "Caring for the Bariatric Patient" (4-5 authors--all work with us, have for years) and protein is the base, carbs at the top.

I'm 14 yrs out, tho, and we started right out on protein supps and NO SUGAR, and NO MILK, low carb, even back in the 90's. Most of us lost 100%. Can't go no carbs, of course, or your brain doesn't work!

Today, I've lost 165, keep it off unless I get into sugar, do 180g in protein supps, and minimize other carbs. I don't tolerate milk, anyway, so no big deal there. My dh lost 110, which put him at his right wt, and he does more carbs than I do, but if his pants get tight, he drops them like a hot potato. The carbs. Not the pants. At least, not in this discussion.

When I had fallen into the sugar vat and had 15 lbs to lose, I went to 20g carbs (net impact carbs) per day and ate ONLY protein food. I had to break the carb addiction and the more protein you get, the less you crave sugars. So, that worked, then I gradually added back in only veggies, fruit, whole grains.

I don't have time to do the math, but 150 g of carbs does NOT sound like too much to me. 

The RD that did my MedGem test (who has specialized in WLS post-ops for YEARS) recommended that 50% of total calories come from carbs.  (You'd get your # by taking your total caloric intake per day and dividing that # by 8 which would equal the total grams of carbs you'd need for that day.)

I have followed this rule. 

I've lost 100% of my excess body weight and have recently had to up my calories because I was STILL losing (albeit slowly now). 

So in my opinion, 150g carbs is NOT too much (assuming that it is not more than your total calories per day divided by 8).

I would like to suggest you go to Atkins.com and do the kickstart program for the 2 weeks, it is high in protein and low in carbs.  I think your carbs are way too high.  You may find that if you can kickstart the weightloss again it will all fall into place.

Anne

Thanks for all the replies.  Since posting the original message 11 days ago, I have dropped 11 lbs.  I boosted my water intake to 100 ounces a day (plain water) and upped my calories for a week to right at 2000 then dropped back down to 1500.  Pumped up the exercise too.  Weight has been falling off.  I think the water has been the big factor for me.  Too much coffee and not enough plain H20.  Also saw a PT and he has me eating either 4 oz of red meat or 1 cup of cottage cheese 30 minutes before bed time on my workout days.  The protein will repair my muscles and feed my body as I sleep.  Dont know what the exact trigger was but I am happy as a clam.  Thanks for all the support...

Dalton

I'm glad to hear that it's working!  I'm  at the same point - I have 30 more lbs I want to lose and as soon as I up'd my workout the 1st of January, the weight loss stopped - I saw where other sites said to up my calories but that's hard to hear when you're geared to 'watch it'.  I'm going to try your solution and hopefully it'll work.  Keep it up - you're doing great!!