Question:
My doctor does not recommend a no carb diet - why is that all I read here?
My doctor does say protien first and at least 64gm per day along with 64 oz. water, but also 5 servings of starch, 2 servings of milk products, 2 servings of fruit and warns against Ketosis. I have met many of his patients and they have been very successful. This is so different from everything I read on this web site. I am only 6 weeks out and have just started on "regular" food. This is confusing to me. You can lose weight on an Adkins type diet without surgery. My whole reason for having this surgery was so I could eat like a normal person and not binge on junk but not eat only protien. Comments? — Gail L. (posted on October 5, 2003)
October 5, 2003
My post surgery diet sounds alot like yours. I am 14 weeks post op &
have lost 70 pounds so it must not be hurting me too bad.I only have 50
pounds to goal weight. I recently was able to add pasta & rice to my
diet which is so different than what we read on here. I have tolerated
macaroni & cheese well (which is high in protein) & still managed
to lose weight so I am not too worried. When I stop losing weight I will be
sure to try the high protein low carb approach that helps so many on this
web site. Just a thought....but I also want to eat like a normal person,
only making better & smaller choices than I did in the past.
— Kathy K.
October 5, 2003
Hello. My doctor recommends a balanced diet but says proteins first. I am
supposed to have 65 grams of proteins a day. I think I have the same diet
plan as you. It is supposed to be a new way of eating not a life long diet.
As long as I get all my protiens then I can eat whatever I want as long as
I am not eating junk. Also I am not supposed to go over 1200 calories a
day. I am only 1 month post op so I cannot eat that much yet. Some of the
things I read here are different from what I am told by my doctor, so I
just do what my doctor says. Everything is going good so far. Good Luck!
— AmyWollet
October 5, 2003
Gail, my nutrionist recommends the same things, a well balanced diet. I
CHOSE, HOWEVER, TO IGNORE HER. B/C if I follow her lead, I won't lose
weight! I do all protein. When I add carbs, starches, fruits, etc to my
diet, I maintain and I don't lose. I must be doing something right as I am
14 mos out next week and I am down 122lbs. Good luck. Heather Open RNY
8-15-03 305/183/150
— heathercross
October 5, 2003
I am still pre-op, but I think I might have a little bit of an answer for
you. I have done atkins and hated it. A while back I tried a diet that is
high in protein but also included whole grains and pasta. They carbs were
in limited quantities and always eaten with high quality protein. I lost
more weight quickly on this diet then on any other diet I have ever been
on. The way I understand it is your body utilizes the carbs differently
when eaten along with high quality protein than when you only eat the
carbs. Don't know it this makes any sense to you but it might explain some
things.
— Christina W.
October 5, 2003
There are too many self appointed experts here who although they would deny
it continue to follow the fads that help lead them here. Follow your docs
plan and you will do fine!
— Laurie B.
October 5, 2003
#1 because it works. #2 I cannot handle carbs and many morbidly obese
people can't either. Many of us are insulin resistant or just plain go into
munch or binge mode after eating carbs. I continually read that people had
this surgery to be "normal" but I think that if you are at the
point where you need surgical intervention to get a grip on your weight you
have just left "normal". I have had to be very vigilant about
changing my habits post op and have noticed that many people just don't in
the quest for "normal" and end up having a very hard time.
Binging has very little to do with the eating but the motivation behind it.
When we have this surgery it is just on our stomachs not on our brains or
the way we think. That has, for me, been the toughest part, changing the
way I relate to food and what I use food for. To think that you will never
want to binge after this surgery is dangerous. All of the same thinking is
still there and must be dealt with. Good luck.
— Carol S.
October 5, 2003
Thanks for giving me an opportunity to get back on my soapbox. Listen to
your doctor. A no-carb or very low carb diet over a long period of time is
not healthy. Your body NEEDS the fiber and nutrients supplied in fruits,
vegetables and whole grains. It is the preferred fuel for your brain, heat
and lungs. Without it, those major organs (and others) will operate, but
not efficiently. With that said, there are two types of carbohydrates.
Those found in fruits, veggies and whole grain, and those found in refined
carbohydrates--white rice, potatooes, and sugar, and flour and items made
with sugar and flour, including sweets, bread, pasta and junk food. The
body does metabolize the refined carbohydrates differently than it does
protein and fat. For many people, that causes an insulin reaction,
signaling the body to store fat. Protein creates a glucogon reaction,
which signals the body to burn fat. As long as you continue to eat more
protein than refined carbohydrates, then you should be fine. Also, keep in
mind that your doctor's version of a "serving" is much less than
a serving would have been pre-op. So, pay attention to the volume of the
foods you eat, and be sure to get a good balance. If you find yourself
having difficulty losing weight AFTER 6 MONTHS, then cut back on the
starches, but keep the rest of the balance. Your doctor is also trying to
give you a more normal diet, that you can more likely stick with for a
lifetime. Just be sure that you always get your protein in first, and that
you do not grow the size of the starch servings. Do what your doc says
first. If that doesn't work (and I'm serious about giving it a full six
months), then modify it, but within reason. Best wishes to you.
— Vespa R.
October 5, 2003
Because there are multitudes of doctors who advise their patients how they
think best. It's best to follow what your doctor recommends. Mine didn't
say no carbs, he said low carbs. I'm supposed to do no more than 30 grams
of carbs a day and so far it's worked very well. Ignore the ones that
claim to know-it-all and do what your surgeon recommends.
— Cathy S.
October 5, 2003
My doc does not believe in an all protein diet....eating RIGHT....and
putting protien first....limit carbs....I personally eat no rice, or pasta.
I am 20 months out ...past goal....and lost 175lbs...open RNY distal.
— Oldsoul
October 5, 2003
I'm still a pre-op, so I'm going to be cautious on this one, but I'm
searching for myself and I've noticed one funny thing about the profiles
I've read here. I spent hours and hours looking at the before and after
photos and reading the profiles of those who looked like they'd never had a
weight problem. Most of them had the same thing in common. They concentrate
on the protein, working really hard to get it all in first, and then eat
fruits and vegetables, then starches last. They also drink lots of water
and get some sort of regular exercise. The people who have the least
trouble (barring the complications that can happen to the "best"
patients) seem to follow the same pattern. My surgeon told me at my consult
that it was a good idea to concentrate on protein first when I asked him
about it. One doc I heard at a support group meeting went so far as to say
we don't really need any carbs at all, though I take that with a grain of
salt. My nutritionist's list included 5 servings of starch, too, and from
my personal experience pre-op, I don't think I'm going to do that, at
least, not 5. For me, those starchy foods are my worst food addiction, and
I'm afraid that even post-op I won't be able to eat them within reason. I'm
afraid I'll slip back into my old habit of eating starch first and having
no room left for protein. My BMI just topped 50 eating my way. That just
has to go and stay gone forever. I'm sure the posts about needing a
balanced diet are probably right, this is just the only way I can think of
to keep myself from slipping right back into the old ways post-op. I WANT
to lose my taste for the things that made me so MO that I have to go
through all this to get the weight off.
— Chyrl W.
October 5, 2003
My doctor and nutritionist also recommends a variety of food...milk, meat,
veggies, fruit and starches. I am suppose to get more meat and milk
products than anything else. I also let myself get caught up in all the no
carb hype, but when I went to see my nutritionist at my 6 month check-up
she actually said I could be eating MORE carbs. Most of my carbs come from
milk products and fruit. Yes, I expected I would be losing at a faster
pace, but I am losing. Also, like previous people have said, there are
nutrients in food with carbs that our bodies need. All my blood levels
were great at 6 months, I take pre-natal vitamin and iron (which I took
before surgery)...but no need for b-12 shots or anything else....I think
eating such a variety of food has contributed to this.
— Sarahlicious
October 5, 2003
I think a lot has to do with what weight you started this journey at. When
you have over 200 lbs to lose you will do basically anything to get off as
much weight as possible in the early times, so that when it slows down
naturally you still can make your goal weight.
<p>My surgeon's plan is devoid of carbs for the first 6 weeks and
then adds in veggies and fruit in small quantities. Essentially over time
one can add in limited refined carbs etc. All carbs are created equal as
far as losing weight so don't think that eating lots of veggies and fruits
can't slow down you weight loss. Balance is what we are all trying to
achieve. Normal is also what we are trying to achieve however, after WLS
there is a new normal. Due to the fact that we will never we able to eat
large quantities of food it is important that protein be the largest
portion of our meals for the rest of our lives to keep our bodies healthy.
We will never likely be able to eat more carbs than protein and stay
healthy. Most normal people who have not had WLS do tend to eat higher
portions of carbs than protein but their bodies know how to deal with it.
<p>Most SMO people know what got them to that state and it wasn't
eating lots of protein. It was living on carbs, so pardon me if eating
significant carbs scares the he!! out of me. I do eat all kinds of carbs
but in limited quantities. This is NORMAL for me now. I don't deprive
myself of anything I want but in general I don't desire a lot of the things
I used to. Even if I do I will have a tiny bite and that's enough. I'm
far enough out to be out of the honeymoon phase and faced with the reality
of managing this food beast for the rest of my life. My body does good by
me as long as I give it what it wants. I sat for two weeks not long ago.
I got it moving by going stricter on protein and pushing water. I am
comfortable that at maintenance that I will be able to maintain and eat a
reasonable amount of carbs. I look at it this way, it's no different than
being diabetic and having to eat a certain way to keep your blood sugars
under control. My surgeon told me I will always be SMO but that with the
tool he gave me I will be able to keep my disease in remission if I use it
wisely. He is right! I will always likely be predisposed to wanting to
gain weight if I give in and start getting my protein and carbs out of
proportion. Giving up a bun on my cheeseburger so that I can eat a couple
of onion rings or bits of potato is no big trade off to me. I could eat
some bun also, but for my body it does affect my weight loss.
<p>I did choose to stay in max ketosis for 4-12 months which meant
zero to max 5-10 carbs a day. I did this with my surgeons blessing and
because it was burning the fat off of me. The lbs weren't dropping like a
stone but the inches were. I took that time to develop a new relationship
with carbs. They no longer control my life and I can eat them without
setting off cravings. I know I am extremely lucky in that respect. I knew
I needed to make some major changes in order to develop new life-long
habits. When it comes to eating my life has never been normal so for me to
expect it to suddenly become normal because I had WLS and not have to make
adjustments would be ridiculous. The way I went about this has worked for
me but it far from the "right" way. It is just one way. Using
maximum ketosis allowed me to not have to use protein drinks as it was not
critical to get in 60 grams of protein early on. To me that was important.
To others they are fine with the protein drinks. Each person has to
figure out what they are comfortable with. I am comfortable with my
"new normal". For me it was choosing to live or die. I got the
chance to live and I needed to make some changes - I can live with that. I
do not see this as an adkins type diet. It is a WLS RNY diet which must
focus on protein to stay healthy. Trying to do Atkins with a normal size
stomach is nuts in my opinion - just way too much protein to consume.
— zoedogcbr
October 5, 2003
Somewhere around my 3 month check up, I used the word "diet" in
conversation with my surgeon. He pointed out that I was no longer on a
diet, I was eating more healthfully and not denying myself anything. Maybe
it is just a head game. I eat my proteins, drink my water and, if I
desire, I eat anything else I want afterwards. I eat the "good,
healthy carbs" and limit the "bad ones". I limit them
because they fill me up too fast. Potato, breads, pasta... fill my pouch
and leave no room for anything else after a couple of bites, so I avoid
them for the most part. I am only about 6 mos out, maybe my tune will
change after a year... I hope not. Listen to your Doc and follow his
plan....it is always a bit easier when you and your Doc are on the same
page! Best of luck to you! Open RNY 255/178/150
— teresa M.
October 6, 2003
Don't worry, just follow what your Dr. says. Ketosis is good for an
occassional kick off but can do serious damage if you stay in it too long.
— mrsmyranow
October 6, 2003
My doctor says concentrate on protein first and then add the rest. With
the size of our pouch - carbs fill it too fast and they have no nutritional
value at all. I usually will eat the protein first and take a couple bites
here and there of potato or veggies. It is important to get our protein
quota per day so we can be healthy. Trust me - you will never eat
"normal" again but you will be healthier than you have ever been.
Take care and God bless!!
— laurab
October 8, 2003
If Atkins worked so great, why would anyone need surgery. I had surgery
because diets just didn't do it. If I were you I would define starches
more clearly. wonder bread and real whole wheat bread are not created
equal. fresh peas and carrots contain a ot of vitamins and are preferable
to white rice. be sure about portion sizes. Most apples are 2-3 portions.
a banan is 2 portions. bread- 1/2 slice is a portion, 1/4 of a bagel. I
used to think 1 bagel was one portion. big news to me to really look at it
and work with a dietician. try looking at what thin healthy people eat. it
is an eye opener. I look at tlunch. they are eating a cup of lettuce with a
couple oz chicken or 1/2 a sandwich. the over weight people are eating a
big giant sandwich and chips and a soda. Good luck to you !
— **willow**
October 8, 2003
I've never been on an "all-protein" diet, and I was never into
keeping myself in ketosis (never bought the sticks or kept track of that).
But, I do eat a lot more protein now (16 months post-op, at or past goal
for 7 months now) than I did as a pre-op, and expect I always will if I
want to keep the weight off. Over time, you'll figure out how much and
what type of carbs you can eat comfortably and still achieve and maintain
your desired weight. You may, or may not, be able to "get away"
with five servings of starches (what a word, lol!), and as Willow says, not
all starches are created equal, and in reality, serving sizes are a heckuva
lot smaller than I ever wanted to acknowledge as a pre-op.<P>One
phrase caught my eye in your question, where you say, Your whole reason for
having the surgery is to eat like a normal person. My take on this is
that, unfortunately, we're not "normal," we're morbidly obese,
and for many of us, that means we cannot get away with eating the types and
amounts of carbs that others can eat, because it triggers overeating in
many of us (whether it's physiological or psychological, it just IS a fact
for many people). Lots of these "food pyramid"-driven docs and
nutritionists ignore that fact, and that's one reason why obesity isn't
being treated very effectively, IMHO. They need to recognize that what
works for one person may not work for another. You can see that in the
different responses you got just to this one question! So, don't be
surprised if it turns out you can't eat like a "normal person,"
whatever you perceive that to be, and still keep your weight off after WLS.
You may have to become a bit of a protein nut, or a carb-gram counter, or
run screaming from anything with more than x grams of sugar, or some
combination of all three. Far too many people regain, or never get to
their desired goal weight, simply because they didn't know, or wouldn't
believe, that as M.O.'s or former M.O.'s, they probably have to eat more
carefully or restrictively than "normal" people. This isn't
necessarily your destiny -- obviously, some of the posters below don't have
a problem with carbs yet, and some never will -- but many, many do. Hence
all the wackiness about "protein."
— Suzy C.
Click Here to Return