Almost a year and only down 30

I have Hashimoto's thyroiditis, Celiac disease, and a litany of other issues. I used to weigh 750+. Currently, I need two knee replacements, have severe degenerative disk disease, and two rotator cuff tears (at 40). I also take antidepressants.

I am the very picture of someone who should not lose weight post-op. I am telling you this because I lost 150ish pounds since my VSG, despite already having lost about 300ish, before stalling. Also, despite my severe inflammatory arthritis, I also take zero pain killers. Don't get me wrong - I am not always comfortable by any means! However I function very well because I follow an appropriate diet to the letter, and this vastly reduced my inflammation. Yeah, it's still hard to walk, however I can chase clients down all day for 12 hours. Yeah, I'm limping on my way out the door. However, that is the difference diet makes regardless of surgery.

To lose weight, I have to eat 80g of protein a day and under 700 calories. I recently started Saxenda and I will only take it until my DS revision. This is miraculous because before that I had to eat 500 calories or less.

Because of my size my body is extremely resistant to weight loss. I basically have to get a DS, which now I am at a good place for health-wise.

The DS or RNY alters the enteroendocrine cells of the intestines; this causes the metabolism to drastically become altered. We do not know why a bypass of any sort (even non-WLS bypasses) do this. They just do?

While obesity is caused by a surplus of energy, it is also a state of hormone dysregulation. It's not just about calories, but about how the body uses them. Both malabsorption and this hormonal "reboot" provide powerful weight loss. Since you have the VSG, the DS is a good choice.

That aside, even with a sleeve and metabolic issues, it's very unusual to lose just 30lbs. I would seriously take a step back and examine what is going on. You need to meticulously track what you eat. With the VSG, we absolutely cannot eat a lot of processed food, fast food, or carbs.

Hi Donna! I'm so sorry for all your pain but I admire your strength. I would love a copy of the diet if you are able. I'm in the hospital I can give you my email address I don't know if there is a way to pm it. I hope you're able to get the DS and I will be seeing my sleeve Dr and talk about what we can do start with diet and if doesn't help consider other options. Thank you for taking time to help :)

My pain is waaaay less. I am actually well, if uncomfortable, most of the time. I am prolonging the time I can be on painkillers late in life. The longer I can hold out the better.

I am happy to post my diet here. It is not for everyone, I know, as it is restrictive. I have allergies and Celiac, so that limits a lot of carby foods naturally. I also eat full-fat foods. I follow a modified ketogenic diet (mine is higher in protein and much lower in calories, and a bit lower in fat). This has the benefit of helping the thyroid, actually, which is very prone to inflammation. There is an auto-immune protocol diet that works very well for hashimoto's; you can google that and find it about. The important thing is to do what works for you. Typically with sleeves we do better lower carb, though, and lower calorie since we lack the bypass benefits.

My first meal is often a protein shake or some bone broth and meat soup. Usually 4-5oz of the latter, and 30g of protein of the former.

My second meal is typically 5-6 ounces of greek yogurt. I usually just have it plain. More rarely, I will put some sugar free jam atop it (just 1-2 tsp). When I get fancy, I make sugar free "granola" from seeds, chopped nuts, and unsweetened coconut toasted. I am lazy, however, so usually not.

My third meal is usually 4-5 ounces of meat (usually 4). I avoid sauces and starches. I'll sometimes have curried meat or other stuff. If I have room I will have 1-2oz of veg, however I usually do not.

Fourth meal varies, and is often one of the above repeated. I don't eat fruit at all, usually, and I try not to eat any grains due to a combination of allergies and severe Celiac.

Again thank you for sharing. I was considering the Paleo diet but it includes veggies and fruit but I wasn't going to eat much fruit. I was carb sensitive before the surgery too. This is almost like what they call a reset diet, which I was going to follow for a few weeks before the Paleo, staying at 1,000 calories. Some days I can't even get up but I push myself and it you do too. I'll start with this and maybe tweak it a bit. Thank you again for your help I'll keep you and everyone here posted :)

My first thought is "Be gentle with yourself. With all your health issues, and pain and anxiety and depression, it must be so hard to stick to the diet. I broke my arm this year (and I am also struggling with anxiety and depression) and I gained 20 pounds in about 20 weeks just over-eating a little bit. I didn't binge, or go heavy on the carbs - it doesn't take much to gain weight.

which brings me to my suggestion: It's all in the diet - its weighing and measuring and tracking the food so you know how many calories you are eating every day. For me, it is hopeless until I white-knuckle-it and get off the carbs. I am very sensitive, and I try to keep my carbs to about 25 g per day. I let myself go up to 40 but there is a slippery slope when they get that high and I start craving carbs, and they overwhelm my will-power.

I think with all you have going on health and stress-wise, you may not be ready to overcome it yet. So be gentle with yourself, you will get there. Trust yourself and do the best you can.

best wishes,

Carol

Thanks Carol. I'm carb sensitive too for sure. I'll keep tracking and hope that helps:)