Question:
Im usually under 400 calories a day, What can happen long term?

I an 5 weeks post op and wondering about the possible side effects of possibly eating too little. Typically my daily is breakfast - 2 string cheese - 160 cal. 16 gr. protein, lunch 1/2 c. no fat cottae cheese - 80 cal. 13 g. proein and supper 1/2 c. chicken breast - 130 cal. and 23 g. protein. This is only about 370 calories a day. 52 g. of protein. Always at least 60 oz. of water a day. However this weekend I got som protein bars in the hopes of upping my potein and got so full from one 2 oz bar that's all I ate all day both sat. and sun. so for 2 days in a row it was only about 200 calories a day. I am just wondering how long I can safely only eating less than 400 caloris a day, o should i already be trying to increase it to more. 5 weeks out of surgery and I have lost 32 lbs. Thanks.    — [Anonymous] (posted on January 14, 2002)

January 14, 2002
I am post op open RNY almost one year, down 133 lbs. to 160 lbs., size 14!! Lookin' and feelin' great! There were many days I only ate 300-500 calories per day. I made sure I ate PROTEIN only - taking my chewable vitamins, calcium citrate, and trying to eat a beet (yes!) or brussel sprout to keep a little bit of veggies in the mix. Gradually I worked in protein drinks (I use Herbalife products) and protein bars. The operative word here is GRADUALLY. I bet your doctor says not to worry about only getting 450 calories now and then - after all, this is the effect of the surgery we chose to endure! I think that as long as you really pay attention to the quality of food you eat, try little by little to add more high-quality protein, take your vitamins and supplemental protein (I believe in it!), you're going to be okay. You'll get lab work soon and if there's a problem, it'll show up and you'll get instructions from your doctor. As soon as you can start walking for exercise and then weight lifting if you want to. This will help keep your metabolism pumped up, increase your weight loss, and tone those muscles. By the way, I still keep a notebook every day listing everything I eat and the calories and protein grams. Some people don't like doing this, but for me it keeps me focused. I still only eat about 800-1,000 calories per day, don't drink carbonated drinks, eat 6 small meals per day. My labs have always been GREAT. The only problem I've had was I had bad thinning of my hair. I expected this, though, as it is a side effect of rapid weight loss and the anesthesia from surgery. My hair is growing back nicely now and I'm so grateful for this wonderful tool. Take care of your pouch and it'll take care of you! I'll post a 1-year-after-surgery picture next week so y'all can see my progress. Take care,
   — Lili R.

January 14, 2002
I must tell you that I am almost 7 weeks post op and I have been having a similar problem. I really try to get the bulk of my protein from supplements. I would have 3 protein shakes a day with 31 grams of protein each. I was mixing those with water. I was only getting about 400 calories in a day, and my weight loss stopped at about 5 to 6 weeks. I have since decided to use skim milk in two of my protein shakes to add another 180 calories plus I am adding cheese as two extra snacks. I started walking more consistently also and I have faith that these changes will make the difference. This is such a complicated process. On the surface it sounds so simple. Burn more calories than you take in and you will lose weight. However, a great deal goes into how efficiently your body uses calories and in turn how quickly calories are burned. My body had gone into a very efficient means of utilizing calories because it could not trust that it would get anymore some time soon to complete basal and lifestyle functions. I was really cheating myself by not consuming more calories. Your body will eventually start to feed on itself for the protein and nutrients that it needs, leaving the fat. I hope this helps. We simply need more calories than 200-400 a day over extended periods of time. When we were newly pre-op it was different, but now we really do need to let our bodies know that we are not starving. Take Care!
   — Faith Pureson

January 14, 2002
Initially few of us are on target for protein or even water. But over time things improve, and hydration is much more important than protein. I finally quit worrying about it and the problem went away. Takes 2 to 3 months for our pouch to stretch enough. Few surgeons admit what they must know, early on its impossible to get enough protein and water in.....
   — bob-haller