14 years post op 50 pound weight gain dietician suggestions

Had open RNY 14 years ago

Never from day one felt restriction most weight loss occurred within the first 3 months of surgery

New bariatric doctor came to our hospital -had him review all my records from St.Louis

EGD done I have Gastro-Gastric Fistula

Had me keep a food diary for 2 weeks set me up with his dietician for review

She said I was "very strict on a 1200 calorie consumption"

She says that my body in starvation mode?

She wanted me on no more than 800 calories a day

working out 2 hours a day 7 days a week

she did not agree with the 80gms at minimum St.Louis program wanted

I told her when I was younger (I am 51 now)that is how I lost weight 500 calories or less knowing now how dangerous this was

My question and this new bariatric doctor agrees the calorie consumption is unrealistic (he said he was going to talk to her I feel she has no idea re. bariatric)

I just want to know what you all think re. calorie -protein- exercise-"starvation mode"

I saw a dietician after a 45 pound regain.  She told me I should NOT go below 1000 calories, and she thought that was too low.  She devised a plan for me based on food groups rather than calorie intake.  I eat more fruits/veggies/protein/dairy and less carbs/starch... no sugar, no alcohol, very little snacky-type stuff.  It worked for me.  I took off the 45 pounds plus some more in about 6 months, and I am maintaining.  I have no idea how many calories I consume in a day, although best I can figure, it's an average of 1400.  I don't think all calories are created equally, though.  Eating 500 calories of crap versus 500 calories of healthy stuff is not the same.  What I eat actually fuels my body.  I have energy and feel amazing.  I do not do a lot of exercise.  I am more active in my daily life -- taking stairs, walking instead of driving, etc. 

Congratulations on losing the gain and maintaining!! Could you possibly give us, that are in the process of trying to do just that, a sample of your menu for a day? I know I would appreciate it and maybe many others!

Susan

Here is my personal food plan.  Please note that I could never do this alone.  I have a WLS support group, and I work the 12-step program of Overeaters Anonymous with a sponsor. 

No sugar. No fast food. No corn chips.

Meal #1 - 7:30 - 8:00 a.m.

1-2 proteins (2 eggs, or 1 egg and 1 oz ham, etc.)

1 grain (1 sl bread or ½ c. oatmeal, etc.)

(I want to be able to throw some veggies into eggs -- onions, peppers, tomatoes, mushrooms)

Meal #2 - 10:30 a.m.

1 piece of fruit or ½ c. cut up fruit

Meal #3 - 1:00 p.m.

2 oz protein with 1 c. raw salad with 1 tbsp dressing or ½ c cooked veggie and 1 starch

OR

Lean Cuisine/Smart Ones with salad or a fruit

OR

Subway meal (turkey/flatbread/veggies/fat free or baked chips) or

McDonald’s meal (salad/grilled chicken/low fat dressing/croutons)

Meal #4 - 3:30 p.m.

Fruit or dairy (I love dannon light and fit flavored greek yogurt)

Meal #5 - 6:30 - 7:30 p.m.

2-3 oz protein with ¼ c. starch and ¼ c. veggie or a salad

(I want to be able to eat 6 oz of lasagna or pizza if it’s planned in place of protein/starch -- but this will be rare)

Meal #6 - 9:30 - 10:00 p.m.

Either a single item or two different items, i.e. dairy or fruit or starch OR fruit/cheese, cereal/milk

Thank you so much for this. I'm trying just makes me mad at me for getting so far off track!! 

Thanks again,

Susan

I'm doing low carb. 30 net carbs. 1250 calories or less. 18 pounds since start of year. It's slow but it's steady. If I go much lower in calories I'm starving by bedtime. 

Hi, I am 43 years old, and 11.5 years post-op from an open RNY Gastric Bypass. I've had no complications in my time, although my body is still changing in regards to what foods work, and what doesn't. 

I initially lost around 125 pounds, and maintained that weight loss (with a 10 pound fluctuation) for about 6 years. I actually lost more weight in early 2009, because of loss of appetite due to painkillers following a complicated knee surgery in 2008. I subsequently had another ortho surgery, in May 2009, and while on crutches and able to do little, I gained weight. Several months later, I cared for my sister after she had gastric bypass (she had some complications). I didn't realize until recently that I had a good 40 pound fluctuation in weight in 2009. I continued to slowly gain weight, then dieted and lost a little. My all time high weight AFTER surgery was 221, in 2012 (I was 297 pre-op, nearly a decade earlier). I went up and down from there, doing half assed attempts at low carb diets (I was making it up as I go along).

Finally, this past March, at 213 lbs, I decided to try the newest version of the Atkins diet (both my boyfriend and I are following Atkins). While it's not been speedy by any means, I have lost 21 pounds in 3.5 months. Admittedly, I used to think that Atkins was an awful diet, but I feel good on this diet. I find that without carbs, I very rarely have that 'one bite too many' feeling, and with limited carbs in my diet, I find that sometimes it's actually quite difficult to hit 1200 calories. I'm actually aiming for a range of 1350-1700 calories. When my calories are lower, I lose slower. WITH Carbs, it's a struggle for me to stay on a low calorie diet, and keeping my calories under 1800 felt impossible. I know this works for my body because carbs most definitely make me hungrier -- I know I am a carb addict.

While it's all very counterintuitive to all I know of dieting and nutrition, I find Atkins works. Without carbs, your body utilizes fat first, and you don't store it. My doctor is okay with this diet, and my bloodwork has been normal . It's been the right method for me, and I feel in control. Atkins was difficult in the early stages, on Induction, where I was trying to stay at 20-25 net carbs. Now I am more in a 50 net carb calorie range.

The Atkins web site is awful for recipes, but there are a lot of good low carb blogs out there, and one can rework their own recipes, as well. The 'New Atkins for You' (or something like that) seems to have more of a focus on veggies than previous versions, and I like that. 

It works for me, and I know everyone's body is different, but for this surgically rearranged chick, I must add that while I miss carbs, I don't miss the gas and bloating that carbs brought. I'm now 192 pounds, and trying to get back down to at least 165. Then I'll take it from there ... 

Edited to add that My Fitness Pal app has been great, and the Atkins Carb Tracker app is a good outline of the phases of the Atkins diet.

I had gastric bypass 10 years ago and went from 220 to 109 (my doctor yelled at me about being too thin) to maintaining a good for me weight of 125-130. Over the past year I gained 40 pounds back. I started doing the Weigh****cher program and make my selections based on the healthiest choices - lean protein, lots of fruits and vegetables, whole grains and my indulgence - very dark chocolate. After I started counting points I realized that drinking wine was to blame for the weight gain. One bottle = a whole day's points. If I don't track my points I end up going over but as long as I write down what I eat, the point value and plan for splurges, I do well. I am not going to the meetings, just using their material. I also like an app called trackmywalk which tells you how far you walked, your pace and the calories burned. It is free.