5 Weeks Post Op - NO Weight Loss

OK Old Timers. I thought I had seen it all on this site and I have even helped a bunch of people past stalls and analyzed what they are doing right or wrong. So I feel like I know what I am doing and how to advise people.

I am stumped on this one. My wife is 5 weeks post op and has lost only 2 lbs since surgery and that was in week 1. Needless to say she is beyond frustrating. She is doing everything right. She is drinking minimum 60 oz of water, 80+ g of protein each day. Staying between 450 and 750 calories each day. She is exercising (walking or light jog) almost every day. She should be losing weight.

I have speculated that she may not actually be getting enough calories. I don't know for sure if she is eating everything she says she is eating.

This is way beyond a stall. I have experienced my fair share of stalls and this does not seem right. She is getting very depressed and feeling defeated and of course she is beginning to feel like the surgery was a huge mistake.

I have tried everything I can think of, what am I missing?

Perhaps time for some blood tests to make sure there isn't some underlying new issue stopping the weight loss if she is following the program to the letter.

Thanks for the reply!

We did that. Iron good, Thyroid function good, no standouts from the blood tests but I did not personally see the details I suspect her sugar maybe been a bit higher than I would like and I would bet her thyroid are within acceptable standards but not high functioning standards.

What, exactly, is she consuming? Give us a sample day or two of meals. 

Thanks for the reply!

She is actually eating well on her plan, she is a stickler for it:

Breakfast - 1 egg and maybe a half a piece of bacon or 1 scrambled egg with a small amount of low fat cheese

Snack - Premier Protein Shake

Lunch - 2 to 3 oz of tuna salad, egg salad, egg drop soup something like that (not all of them, just one)

Snack - Greek Yogurt with cucumbers

Dinner - 2 oz of Salmon

She is not to full food yet, so ist still softs. 

She is getting 60 to 80 oz of water each day and is walking 1 to 3 miles each day

takes her vitamins like clockwork.

Since medical issues have been ruled out, I would recommend increased liquids and patience.  

Any chance it's a sodium issue? Bacon, cheese, soups can have a fair amount of salt and she may be ultra sensitive to it as her stomach heals. Fluid retention is a b*tch and can affect the scale.

It could be, she does use a lot of salt and in my experience that has not been much of an issue because when you are low carb and dieting we need more salt and/or electrolytes. I have advised her to reduce her salt to see what happens. 

The good news is the scale started moving (2 lbs in 2 days) and her mood and general demeanor has improved greatly.

k

Hey Keith, 

Just going to say it: You know that too few calories theory is total crap. There is a large amount of scientific evidence to now contradict the 30+ year old theory (that incidentally was not based on scientific evidence!). We could discuss the dynamics of reduced calories, muscle loss and metabolism, but the idea of the body not losing weight due to lack of calories is just bad science. 

With that out of the way, I've got some ideas on what might be the issue:

The first thing I would do is ask her PCP to rule out hypo thyroid. Most bariatric clinics don't test for this prior to surgery. It's good to have a baseline anyhow. Low thyroid could be playing a major role, if that is indeed the case. 

The other area to investigate is medications. There are several mood stabilizing drugs that cause the body to hold on or gain weight. There are alternatives to those meds. 

Weighing, measuring and tracking macro nutrients are imperative. Protein 80-100 grams, fewer than 40 carbs and let the rest fats fall where they may. I am not a proponent of adding a lot of extra fat during WL. I think it can be counter productive (e.g. coconut oil or grass fed butter in coffee and that sort of thing). 

Last, and you can shoot me for this, but is it possible that she is eating things off program (nibbling) without realizing the damage it's doing or possibly in secret? As outlandish as that may seem, I have seen that a few times before. 

If she truly is doing everything right as you say, I"d recommend keeping the calories below 600 for a full week and see what happens. If she still isn't losing by doing all of the above, my guess would be an underlying medical issue. 

I honestly hope you find the answer. I'm sure your wife is beyond frustrated. My heart goes out to her. Please give her my best and wish her luck for me! 

Thanks for the reply!

We've been through all of this. She is right on in this respect. I don't think she is nibbling, she is being super anal about sticking to her program. We did get thyroid ruled out, but I need to see the actual test results to see if its on the low side of normal. She is still on her Lisinopril for high blood pressure but I don't see anything on it that would indicate it is the cause, rather the opposite that it improves kidney function so it should be cleansing her better. She has had thyroid problems in the past so I am leaning toward that, but her latest test came back "normal".

She is below 600 calories a lot of days and I think the days she hits 600 its because she logged more than she actually ate.

I may have her stop her blood pressure meds for a couple of days to see what happens. She is not at risk.

I have different opinions on fat and too few calories based on personal experience but she it not adding fats either, so I can rule that out too. I think her body was used to getting 3000+ calories per day before surgery and is not getting 600 and its is in a WTF mode. But I have nothing to back that up.