8 years out and need help

I'm actually an old member here, I signed up months before my surgery in 2007 but I forgot my login info. But anyway, I'm really at the end of my rope here and not sure what to do. 

I lost 200lbs out of the 240 I wanted to lose back when I had my surgery. Which is a great loss, but I've regained 18lbs -- which I'm sure to most isn't that much but 18 can become 28 and then 38 and so on if you aren't careful and I'm really trying to be. I put on my first 10lbs when I became anemic -- I had maintained my weight easily for 5 years and then it kinda piled on all at once. I really didn't think I was doing anything different diet and exercise wise. 

Then the last 8 has creeped on in the 12-15 months seemingly due to dieting. Every time I diet I add a couple of pounds extra. I've tried varying forms of low carb diets coupled with calorie counting-- this includes Atkins, South Beach, carb cycling, paleo, etc. None of them have produced weight loss beyond the initial few pounds of water weight. I've stuck to each of them for a minimum of 3 months and no results. Most of them except paleo made me feel like crap to the point where I couldn't exercise at all because of the lethargy and dizziness. To avoid that I had to keep my carbs at 60-80g a day and then it went away and I felt good and I could exercise. Which I did pretty extensively. I was hiking 20 miles a week and lifting weights 2x/week and eating about 1300 calories (at 200lbs) mainly from protein. And yet, no weight loss.  

I even went to a nutritionist familiar with RNY at had a Medgem test to see what my RMR is. The machine spit out 1580 as my BMR. Multipled by 1.3 for lightly active,  that's 2054 for maintenance. Eating 1300 calories I really should've lost at least one pound per week. I lost nothing.  

I feel rather doomed if that doesn't produce weight loss. That was my last try and then I was diagnosed with a herniated disc and not allowed to do any exercise except light/modified yoga and walking (not hiking, walking) and light swimming. Maintenance calories for sedentary is 1896 and I only ever eat UP TO that IF I have exercised. Most days I log about 1500 calories and I'm perfectly sated at that level. No losses, of course.

I've even subtracted -500 from the 1580 BMR to see if her using the multiplier (which the MedGem website does say to use) was the problem, meaning I was eating 1080 calories a day. Which was really tough because to get enough protein, I was back into Atkins level of low carb and felt like crap again. Not to mention, I stayed hungry. No weight loss there, either.  

I tried going to the support group from my surgeon and it's all just newbies who don't want me spoiling their honeymoon phase with the reality of long-term post-op weight control.  My surgeon and his team in general hasn't been helpful whatsoever. I'm old news, I guess. 

I can't get on the scale anymore. It keeps triggering my old eating disorder to get on the scale and see those numbers and then I wind up in starve/binge cycles. Granted, I cant EVEN binge like before surgery and I do far more with the starvation side of it now as opposed to pre-op, but it's an unhealthy and useless thing to engage in. 

I almost wish I could say there was a mechanical failure in my surgery and I was eating like I was pre-op, but I'm not. I could put away 4,000 calories without thinking pre-op and now it's work to eat my 1896 "maintenance" calories when I'm eating at 50% of my calories from protein. In other words, I don't think my pouch/stoma is stretched. 

I'm completely at a loss here. Or, well, not...  

I follow LCHF diet.  I can maintain our lose with on it, if i make sure that i choose my carbs very carefully, and don't get too many protein. 

Straches,fruits, are out when i want to lose.

Only non starchy carbs...not processed foods (non protein bars).

Our body releases insulin when www eat Proteins - like meat, dairy..insulin inn or system prevents fat burning. 

(Google food insulin index).

What works for me is too eat 2:2:1 ratio fat:proteins: carbs, with more fat than proteins most meals. 

And not a lot of carbs. 

Not to much calories, But not too little. Natural fats like meat, ghee, coconut oil, avocado, olives. 

Moderate exercise - like walking and yoga. 

Post some of typical menu you eat a day.  

Plus i follow IF method of eating. Every 24 hrs i make sure that for 12-16 hr (typical 14 hr) i only drink calor u e free drinks like coffee, tea , water. 

For my system, my "fast" it's from 9pm - 11am the next day. ( or 12 )

I need LNS because i had too many middle of the night sugar crashes (very low sugar)

A typical day might look like this: 

Breakfast: 

Egg and cheese omelette
Cream cheese on half of a high protein muffin. (Usually flax since it's low carb). OR cottage cheese with cut up fruit if I'm off that day and about to go out and do something active.  

Mid-morning: 
Protein shake or bar. Or nothing. Depends If I have time. 

Lunch:

Buffalo chicken wrap with cucumber and avocado on a whole wheat wrap

Snack:

Nuts or protein bar/shake. Or nothing. Once again, depends on how busy I am and if I'm exercising that day. 

Dinner:

Meat/fish/poultry and at least two vegetables. I most often do garden salads with red leaf lettuce, organic grape tomatoes, cucumber, carrot slices, and sometimes avocado slices. I make my own olive oil and vinegar dressing. I might pair that with, say, boiled spinach or turnip greens which are my favorite. I also sometimes eat a slice of artisian bread from a real bakery depending on the meal but it doesn't always go with the meal or whatever other reason I don't want to eat it.   

Dessert:

1 serving 70% organic dark chocolate 

OR baked apples. 

And I don't drink. Not even wine. I get drunk really hard and really fast and it's really no fun. I otherwise mainly drink blac****d tea with stevia and water. I have diet soda once or twice a month, which purposefully correlates to how often I eat out at restaurants. 

I've weighed and weighed my food over and over again wondering if I'm just overeating -- and I always end up about 4-6oz of a meat or fish at the most. I will usually eyeball a cut of meat and decide what I "should" eat and weigh it to test myself and comes out to that. Which is about what to expect after 8 years. I've done the so-called "cottage cheese test" except I use steak because cottage cheese might as well be a slider food and that's a ridiculous test for long term post ops. Anyway, I can fit as much as 6oz if I stuff it in and don't eat anything else. And it takes me 3-4 hours to be hungry again. So I've ruled out a stretched pouch, I think. 

I'm not sure how to do a true LCHF diet with the usual 65% fat and 5-10% carbs. I still dump on fat pretty readily and super low carbs make me feel terrible, even after months. I do not "get used it when my body transitions to burning fat" as some have suggested I would. I'm still lethargic and dizzy.

Have you have your thyroid checked?  I avoid soy. Soy makes me very tired, sluggish, and affects my tyroids (beside me being allergic to it)

Low carbs can be tricky if you don't get enough salt, and fats. I can't do low carbs, high proteins and low fat...

I get 70-80 gr of proteins a day. 30 gr carbs. 1200 -1400 call . that gives me 700/900 call from fat ~ 75-95 gr of fat a day, in divided dosages.. 

Some protein bars are like glorified candies , i.e Quest bars make me dump and really raise my BS way too high.  I was gaining weight like crazy when i was eating Quest or Atkins bars, even on low calorie diet. My body was treating the so called fiber and SA as real sugars. I was able to digest them and absorb them. 

Here is what i do when i am losing:

7 am coffee, black . w stevia and miralx

Tea, water, until 12 pm.

12 pm - meat or fish, 1/2 avocado, greans...

2 or 3 pm 1/2 avocado, meat or fish, or eggs or homemade low carb bread with homemade mayo, cold cuts

5-6 pm Another snack/ meal as above; handful of nuts (almonds, or pecans or macadamia)

8-9 pm dinner - meat and veggies

10 pm - if needed LNS - in only - when my cal - fat were too low i would eat 1 -2 oz of macadamia mixed with brazil nuts, 

Exercise ~ yoga, or walking.

On 2 weeks diet like that i can lose 3 lbs or so.

If i choose low fat meats - i try adding coconut oil, or add bacon, olives,  mayo, etc..or add fat bomb as a treat.. 

Each meal needs to be balanced for me, not too many proteins, or to many fats at one time. 

Some fats does not bother me. Other. I get "fat flush". 

I can't lose weight if i eat starches. So no grain for me. Even in maintenance. 

When i try to maintain... I may add some berries, dark chocolate... Etc. I use 85% chocolate. 72 Had to many success for me. 

Btw- I am active, big frame. I currently weigh 161 lbs, wear size 6-8 bottom, 10 -12 tops. Size 6-10 dresses. 

I am on a way too lose 5-8 lbs...in the next 2 months.  No more than that.  Less than 155 is not going too look good on me..(too thin for my frame).

I just got back from skiing...low carb and all.

My "snack to go" is individually packed almond butter (Justin's). 

Or my own recipe "biscotti" or cookies..

Halina's simple cookies or bread

1 cup almond butter (NSA)

1/2 cup shredded coconut

1/4 cup coconut milk  (unsweet)

4 eggs...

1/2 tsp baking powder

For cookies: add  liquid stevia to taste, flavors and pinch of salt. 

For Bread - buns - add ground caraway seeds, salt and pepper..

Mix all very well . bake in muffin top pan, or muffin pan, or shallow form. At 350 for 15-25min ****il done).

Keep in a fridge.  Or freezer.

For sweet biscotti like - slice thin, and dry in dehydrator or warm oven (190) to remove moisture. Warm oven to 190..keep it warm for 2 hrs., turn off and leave cookies in the oven.  When cool check if dry enough. If not - rep trepeat the process.  When dry - they keep anywhere..in the car, the purse, the desk In a ziplock bag.  

I typically make 4 dozens.. It takes me app 1hr including baking and cleaning. Drying takes 2 more day...

Very handy..and i know how my body reacts to it. 

When i want dense cookies - i add ground  flax or Chia. Then form more sense cookies...and bake and dry them.  Or add more low crabs chopped nuts..or seeds. 

Apologies for the stupid questions, but what is the LCHF diet and what are you referring to when you say LNS?

Lchf- low carb high fat

Lns -late night snack...

I respect that you are alarmed at 18 pounds and doing something about it.  I had two regains and were more than 18 pounds.  You've reached out for support and taking charge which is great.

You're focusing on the number of calories you're eating, but what type of calories are they?  The type of calories are important.  If you're eating simple carbs, that's a problem.  As a RNY post-op, I eat lean protein first, followed by vegetables primarily.  I will eat complex carbs and fruits in limited moderation.  However, I'm not able to workout like you are!!

With all the working out you've done, no weight loss, I would guess that your body has changed in being more toned and firm.  That won't show up on the scale but will in your clothes.  Could you go back to the nutritionist you saw before (or see a new one) to work with on what you're eating and working out?  Is your BMI still in the normal range?  For some RNYers, we experience a bit of a bounce back that is easier to maintain.  Could this be what it is for you?

Consider joining the Back On Track Together group so we can support you there too.

Heh, I was alarmed when I up 5lbs and it wasn't going away with my usual methods. 18lbs is effing scary at this point. That's 12 more times I got on the scale and was "failing." 

I posted a menu above. You can see where the calories come from. It's about 45-50% protein. I really wish that my body was all fit and toned! If it is, I can't see it beneath this fat and loose skin. My endurance is good. That's as much as I can say about it. 

I went to the NUT several times and she was happy with my diet and exercise and couldn't give me any answers on why I wasn't losing. I went to several doctors, endocrinologists, naturopaths, osteopaths... you name it. They ran tests and they were divided about my having a thyroid disorder. Some said yes, you have all the symptoms, and you show a problem with converting the thyroid hormone and you show some elevated antibodies suggesting autoimmune disorder. Others said no, your TSH is fine, don't worry about it. My iron stays too low for me try thyroid meds to see if it helps. I always get a specific reaction because of that. I won't be able to see a hematologist until March. 

My BMI was never in the "normal" zone and I don't have good feelings about that chart anyway. Not when I've got about 20lbs of excess skin. As I said in my first post, I lost 200lbs out of 240 of excess weight. I didn't get down to my goal weight in the first place, but I very easily maintained that 200lb loss for 5 years with no problems until I had the anemia. I cant imagine my body to experience bounce back after a.) 5 years and b.) when I never did reach goal and was still "overweight." I went from a size 34 to a size 14, now a 16. So I was never anything remotely close to needing the "bounce back" that some who get under goal wind up getting. 

I've developed this crazy philosophy along my journey.  When I eat what I am supposed to eat, I weigh what I am supposed to weigh.  I've learned to trust my body.  I am happy eating about 1400 calories a day.  I feel satisfied there.  Could I tweak it and cut calories here and there?  Sure!  Could I give up all complex carbs?  Sure!  But I don't think I could maintain that for very long, and it would make me sad.  My weight is what it is.  It's not as low as some people's.  I wear size 14 pants and medium tops.  At one point in my journey I had a large regain, which was able to lose by following directions, eating healthy foods in healthy portions.  I've given up the diet mentality and the need for MORE weight loss.  I do watch the scale, but only about once a month, just to make sure it's not developing a pattern of going up, at which time I would need to assess if I have stopped weighing measuring or if I put some not so healthy foods back into my diet.  I guess what I'm trying to say that if your nutritionist is happy with your diet and exercise, maybe you need to learn to be happy with a different number on the scale.  The only other thing I would point out is that I'm not sure how often you are weighing in.  Maybe I missed that.  It could take weeks or even months to see a noticeable difference -- for your body to kind of catch up with your revised way of eating.  My scale and I do not get along.  It plays games with my head even now (7+ years out).  I only weigh in at my nutritionist's office, and I trust her when she says things like, "That's exactly where I want you to be," like she did last time, even though I had expected a weight loss.  Tricky stuff this WLS.

The diet mentality is tough for me. Before this regain I had stopped worrying about weight entirely. I was a size 14 sure, but I had lost 200lbs and was keeping it off. I felt fine. And I thought I looked fine, too. I weighed monthly and my weight was pretty stable. The most it had ever been in my entire life. 

And I don't understand why in the world my body would want to gain back 18lbs when it stayed where it was for 5 years. Effortlessly. 

When I'm dieting I weigh weekly. Right now, I can't take the mental torture of a diet program. I log my food intake but I don't weigh myself. There is nothing useful to be had in the depression that will result. So I don't.  When I choose a diet however, I stick with it for 3 months minimum. If I see no weight loss, no loss of inches and no loss of clothing size, I figure it's time to hang it up. Especially when the low carb was making me feel so crappy, I was just done with it. Feeling bad with no results is no way to go. 

Before THIS weight gain, I'd experienced gains of 3-4 pounds. And then I'd cut carbs back some and eat more protein and maybe exercise just a little more and the 3-4lbs was gone within 2 weeks. And then one day I noticed on the scale I gained 5lbs and tried the same thing with no results. And then the scale has kept going up slowly since.