RNY Nutrition Help (LONG sorry!!)

Hello everyone...new to this forum (joined OH years ago). Glad to see there is something like this here! I had RNY in May of '08. I went from 361-347 prior to surgery and down to 225 after. Stayed hovering there until I went back to school last fall, and stopped "paying attention" and following the "rules" and one thing led to another and I started eating "junk" and stopped working at proper portions, etc. I realized this fall that I'd gained 15 lbs over the last year. This was especially disappointing since I'd like to lose 50 more still.

Sooo...I went back to very basic basics...to curb the "carb monster" I went on clear liquids and protein shakes for a week. Drank 80 oz in clear liquids (and sugar free jello and popsicles too), 5 protein shakes a day, and 3+ liters of water. Lost all 15 that week! The next week I went on to measure 3 meals a day of no more than a cup each, worked at getting 30g protein per meal, and ate things mostly protein with very little carbs (chicken salad, bean/chicken stew, turkey meatballs in a little tomato sauce, etc), still got 3+ liters of water per day and while I didn't take 5 protein shakes a day, still got 3-4 in addition to 3 meals a day. Lost 2 more pounds that week.

I moved on from there to where I am now, 3 meals a day, around a cup each, consisting of about 50-75% protein, and 25-50% veggie carbs, for a total around 30g protein each. I have one snack when I get hungry in the pm (usually Fage w a little sf pudding mix or some splenda and vanilla), and two protein shakes (one when I first wake up, and one mid afternoon). I am getting about 1300 calories, with about 60% coming from protein, 17% from carbs (only 7% sugar), and 25% fat (only 8% sat fat). In grams, I get about 180-200g protein, 45-70g carbs, and 20-40g fat (on the fat end of things, I do almond milk and I do olive oil for cooking, so a lot of my fat is mono, very low sat fat less than 10 g usually 5 or less).

Prior to going back to basics, I was eating a large meal in size, like before RNY! I could eat a whole plate of spaghetti and a salad, or a large steak, potato and vegetables, etc. AFTER the liquid portion of my back on track, my stomach seems to have adjusted and while I "could" eat more, I do find myself satisfied around a cup of food (or like 3-4 oz meat and a half cup of veggies). I get a deep sigh about then, which I was taught is a "soft stop" (a message your body sends to you when you are satisfied, a burp, a runny nose, hiccups, a deep sigh, etc, different for everyone). So I try to be very disciplined about stopping and not having more, even if there's "only one bite" left lol.

Also I completely stopped drinking with my meals. I dont' drink for 30 minutes before or an hour after (30 minutes after protein shakes). That was another habit I'd gotten away from!

I am only now starting to excercise. I am active as far as I have 3 young kids, a business to run, a household to take care of etc, but NO formal excercise which I am also implementing next. (Wanted to get a handle on calories going in first, and now I want to get a handle on getting calories out!)

So here's the thing, my surgeon suggests the following: 

No starches during weight loss, even whole grains. He says to avoid even those while we are in weight loss, and to add whole grains once we reach goal, during maintenance, and then it's only very small amounts. I don't have issue with that bc his method is LOW CARB for weight loss. What I do wonder is if whole grain low carb items are ok (like low carb wraps/breads). I've been using lettuce leaves for sandwiches/burgers which is fine, but what about when I make tacos, enchiladas, etc?

Avoid high sugar fruits like banana, watermelon, etc. Very limited low gly fruits. Veggies ok, but small portions, after eating protein first.

He wants me taking 4-5 protein shakes in addition to 3 meals of high protein daily. If I did this, it would be 210-240g protein a day, and an more like 15-1600 cals. That seems like an aweful lot. He does say the following...he wants us doing the shakes in 4 oz or less of liquid so it's fairly thick and sits in the pouch, and he likes the liquid whey isolate over solid protein bc we absorb it better than food protein. He doesn't suggest replacing food with it, just adding it in addition to food. He said when we eat food we get SOME protein, when we do the shakes (w the 4 oz) we get a lot more of the protein. This is why he suggests the shakes over snacks. The thing is, he was suggesting 4-5 shakes early out bc obviously we couldn't eat that much at the time so I know his thinking there. But last year when I went in, they didn't say to do anything different. I was only getting a few shakes at the time (just laziness) and I told them that, and they said to add "at least" one more. So they acted like they still wanted me getting at least 3 or 4. I need to go back and get current labwork, and when I do I will specifically discuss this with them bc I'm confused!

I'm sorry for the long post, but thought I should be thorough in what I am doing, before asking for your feedback...

Sooo....I'm curious to hear from you all what your NUT says, or what has been suggested for you at your current doctor's visits as far as:
1) How many calories are needed if we are trying to lose? (not for maintenance)
2) How many g of protein/carbs/fat are you told to get? (again for loss, not maintenance)
3) Are you advised to use protein shakes or to snack?
4) Were you advised to avoid whole grains during weight loss? Or did you implement them successfully? Or did you use low carb products successfully?
5) What size of meals are you advised to be eating?
6) What do you think about my surgeon's advice, and why?
7) Am I doing this right?!

By "during weight loss/for loss" I don't mean the early out, everything's going fast phase lol, because obviously I'm out of that by now. I mean, if any of you tried losing, under doctor or NUT care AFTER that phase...I'd especially be interested in that!

Thank you thank you thank you in advance for your feedback...I'm interested to hear from you!

PS I'm getting all vitamins as per lab recommendations, that wasn't a falling place for me, so no worries there...

 Hi there:

I read your post and basically I can tell you what works for me.  I have done mostly what you are doing but my calories for weight loss started at 600-800 and I am now between 800-1000.  My proteins are 90-100 grams.  My carbs average around 70 grams a day.  If I added another two shakes to my diet plan we would be close to matching proteins and calories.  I do walk 4-6 miles a day, every day.  I have been on this new lifestyle for 5 1/2 months and have lossed 48 pounds.  I am 5 1/2 years out from WLS Surgery-RNY.  I do include whole wheat grains such as Sandwich Thins, low carb wraps in my plan about 3 times a week.  I hope this helps you.  Please come and join us daily on the Cardio and Cafe.  It is a great way to be accountable each and every day.

  i know this post is not for me but quite helpful ! 

Hi Tess.
Thank you, that was very helpful. I am going to be discussing the shakes with my doc, and everything else that's going on, and see what I can't do to get the cals down a bit more. And most definitely the exercise will help a lot! What is Cardio and Cafe? And where do I find it on here?
Thanks again! 
Lisa

 Hi Lisa:

We post daily here on Cardio and Cafe.  It is just a way of being accountable for your daily eats and exercise.  It is like putting it out there, the good, the bad and sometimes the really ugly.  It helps me to know what is going in my mouth daily and what exercise I am doing to prevent regain and start losing again.  Come join us.

I think you have great team.  I had to figure all that by myself.
To lose and maintain I do need to get 1000-1200 cal per day. Maintenance 1200-1400.
With lots of proteins, low carbs and good fats.
Now I am on 1200 cal per day (trying) with 150gr prot, 40 gr fat and 60 carbs but 20 fiber so virtually 40 carbs, and only 10 sugars.  That works for me - though slowly... maybe 1 lb a week loss ? More if I do exercise a lot it would be better
First, when you start low carbing , you lose a lot of water - the body needs water to store glycogen in the liver and the muscles.. in my case that is 5-8 lbs.  So I will be able to go back to maintenance when I lose all my weight + 5 lbs... So when I go back to eating more carbs- the initial regain will be fine. 

I try not to eat any grain carbs, but try and suceased - is another story.  When I really, really want some , I eat the whole grain flat-outs... 1/2 or 1 usually  is enough to help with cravings.  

I do limit my daily servings to 1-2 fruits servings a day. And limit veggies that have more sugar (peas, carrots, beets, tomatoes, etc),  Cucs and peppers are fine. broccoli, mushrooms, etc.  
I do avoid fruits that are high in sugar.  Most of the time - none at all.. even in maintenance . The high sugar fruits trigger my sugar cravings and may cause RH... not going there.  

If you are active and losing weight on 1400-1600 cal - then do it. If not - limit the cal. I would eliminate an extra shake. Not fat.  Fat is my friend.  Keeps me full and happy. Extra proteins will - may turn into sugars in the body - fat - not so much.  I make sure my shake has fat + proteins. i.e. almond milk + whey isolate (no sugar, carbs) . Great shake. If I get really hungry I may even add 1 tsp of real (natural) PB to the shake. 

 

 Hey Hala,

Did you realize that you and qtbcmom above have the same surgery date?  

lol... no I did not... thanks for pointing that out,,,

Hi Hala.
Thank you for answering, your info was very helpful as well. I am not getting 14-1600 cal, but if I did take all the shakes my doc mentioned, I would be! I am getting around 1300 and I'd like to shave off about 2-300 more. I am playing around to see what I can do about that. I am losing but too slow for my taste. Probably less than a lb a week now, and I think if I cut a few more calories and get some good exercise in that will do it. Fat is also my friend, I find that when my fats (the good ones) are included I feel fuller and my skin seems happy too lol. Thanks again for the info, you all are very helpful!
Lisa

PS good surgery date ;D (as Tess pointed out)