Dr. Elliot - we have some questions

Since there are a few of us trying to stay on track (get on track) we are wondering at 4+ years out, what should out calorie intake vs. calorie burning be?

And for water we should aim for 60+ oz a day, trying to hold off about 1 hour after eating before beginning to drink again, correct?

Anyone else have a question, add it on.? :)

without taking 500 different supplements,  is there one good multi-vitamin we can take and absorb ...i have had problems in the past year with iron deficiency and vitamin d deficiency 

should i be taking liquid still or is pill form ok?

thanks-
dawn

court.. you covered what i need to know.. i just work out and burn sometimes 800 calories doing cardio and i give myself a 1,100 day  of calories i can consume.. but with working out that number goes up but i still stay in the 1,100 so im burning more and not losing it as fast... very confusing.. lol   im thinking about getting a trainer..  im told to drink more protein and water and it will come off.. but im drinking about 75oz of water daily now.. and i get about 75g plus of protein daily

id love to know the answer..

thank you Beth

Hi y'all,
Thanks for your questions.  Sorry been out of the loop for a few days.  As far as "steady-state" post-RNY calorie intake, there are no hard & fast rules or data.  I try to get my patients, long-term, to get out of burden of having to count calories or grams of protein every day for the rest of their lives.  Rather, I think healthy habits may help them keep weight stable as well as their sanity!
These habits include:
1) Three (not 2, not 6) solid meals (not soup, not yogurt) daily, each no bigger than one-1.25 cup in size (and, yes, you have to MEASURE that meal at least once a day because your eyes will LIE to you about how big your meal is!!), and each consisting, half of good protein (meat, egg, fish) & half green veggies; SCANT amounts (< 1 TBSP) starch like potatoes & even fruit.  Watch the sauces, gravies, salad dressings (use "spritzer" instead of Ranch....)
2)Hydration:  at least 48 ounces , preferably 60 ounces daily liquids a) non-carbonated! b) no calories!! (yes, there are calories in fruit juice, lattes, sweet tea, Gatorade, skim milk; cut out protein drinks between meals too - you don't need extra protein if you're eating meals right); c) between meals (don't drink with meals or 60-90 minutes afterward).
3) No other calories between meals: keep a journal to see if you're sneaking in calories - coffee creamer, handful of nuts or crackers at work, nighttime TV-watching deserts etc. Also watch for those liquid calories.
4) Exercise! At least 3 days a week.
With this, I would think most individuals should be getting 1200-1500 cal  a day, balanced by similar expenditure with exercise.
If you're following these guidelines and a) 1.25 cup food doesn't fill you up, 2) you're getting STARVED 3 hours after meal and c) you know you're not drinking with or within 1 hour after meal, it could mean your pouch or stoma are stretched, & you might benefit from having your surgeon check it out.

Oh, forgot: vitamins.
I usually recommend Flinstones Complete or Centrum Chewable, initially 2 daily in AM for 1st 6 months (when meal size is < 1/2 cup) and 1 daily thereafter, forever.
Only other supplement needed is Calcium/Vitamin D (you can't take calcium with iron, as they interfer with each other's absorption); calcium is best absorbed in afternoon, so I recommend a Viactive Chew after lunch & 1 after dinner - almost like a desert!

Oh yeah PS to my "healthy habits" above:  that's for MAINTAINING weight in RNY steady state.  If you want to LOSE more:
a)  increase exercise to 5-6 days per week
b) no snacks at all

If a RNY patient finds they're losing TOO MUCH weight (which occasionally happens), I'd rather them add 1-2 healthy snacks/day (deli meat, fruit; not Snickers or Nabs) than increase meal size or give up on exercise