Food talk with the Vets - brain all confused after Dietician

on 11/8/17 5:53 pm

Hi Everyone

I had my 1 month post op appointment with the clinical dietician at our program. I am currently get around 70g of protein on average and hovering around 700cals and try to stay around 20g carbs. I pretty much live on meat, eggs and cheese.

She wants me to be around 1200cals a day with carbs at every meal including whole grain toast and rice, and wants more fruits and vegetables. She also wants to see my serving size increased from my current comfort zone of 1/2 cup to 3/4cup per meal. I know I have seen lots of posts about keeping calories low (600-700) and carbs low.

I just wanted to get some clarification and to make some sense out of getting fibre in and the fruit/veggies for the vitamin a and c. What do you do? I have added in some flax seed thinking at least a tbs is g for g with carbs and protein. Do you guys just hold off on it all until maintenance? Did you have through the loss period? I know everyone is so different and every center tells you something different but I just want to make sure that I am going to do what will be the most beneficial for my loss but also making sure my health is in check.

As an aside, I have severe (but under control) hashimotos hypothyroidism so I have blood testing every 3 months minimum so I can get the panels done to make sure all my levels are okay.

Lap Band - 07/08 (not filled long) Referral OBN 04/16, Orientation 09/16, Nutrition Workshop 4/7/17, Nurse 4/24/17, Psych 5/15/17, Dietician 5/24/17, Internist 6/13/17 Consent 7/10/17 Surgery 9/29/2017

HW 4/17: 267 Opti Start 9/16/17: 254 Surgery 9/29: 240.8 M1:-18 M2:-14 M3:-9 M4:-5 M5:-6

on 11/8/17 6:52 pm

I would smile and nod and do what you are doing. 1200 calories is way too many at this stage and adding bread and rice and thing like that is a slippery slope you want to avoid.

My dietician had me under 1000 calories the first year. As far as carbs go there is no reason you have to eat bread or rice. There are healthier ways of getting in your carbs if you need them and you don't.

It sounds like you are doing fine. I stuck to my original plan to a T until I reached my goal and only than did I gradually add a little more volume and calories, maybe 100 extra calories a wee****il you get the the happy place where what you are taking is is the same as what your are burning.

If you aren't comfortable with what this person is telling you you may want to find someone who has a better understanding of a healthy post op way of eating..

WLS 10/28/2002 Revision 7/23/2010

High Weight  (2002) 240 Revision Weight (2010) 220 Current Weight 115.

on 11/8/17 7:40 pm

EXACTLY! I agree with everything in post of Ladytazz above.

The only thing I would add, or ask? Is YOUR energy level sufficient? IF your energy level is low or you become weak between meals, then consider an added balance of a serv. protein w/ 1/2 serv carb exchange. I can't fanthom advise to anyone who has had surgery to suddenly add 300-500 calories a day.. this sounds counter productive...

The lower your carbs are the less you will crave them... and should you have cravings, My surgeon had me add B complex extra dose a day, within a few days craving was gone...

If you increase your serving sizes, you permanently stretch your pouch... that will come naturally soon enough. Mnay years after surgery...Mine is all way up to 6 ounces.(after surgery was one ounce) . Your pouch is the tool you have for the rest of your life. Take good care of it and it will take care of your needs.

Vitamins? thats why we have sublinguals , B complex etc, and collodial minerals, chewable Vitamin C is cheap.

on 11/8/17 7:31 pm

I'm hardly a vet at not quite yet 5 months post-op, but I keep my calories to under 600 (and often under 500), and I keep my carbs to under 35 per day (and often quite lower). My opinion is that you should maintain a caloric level under 600, too. It will never again be so easy to lose pounds as it is right now. Take full advantage of this state, it won't last forever. Keep your protein high and your carbs low to maximize your loss. There is no good reason IMO to add in toast and rice! In time, well cooked (soft) low carb veggies can be added into your diet, and later still, a small amount of low carb fruits. Protein should remain forward.

Do what you feel best, but if it was me, I would shine the dietician on without arguing, while giving more weight to the advice of those here who have successfully lost major weight, and kept it off; I would do my best to mimic their success.

Wishing you a wonderful journey!

on 11/9/17 3:25 am
RNY on 02/28/17

I'm 8.5 months post surgery so I'm not a long term vet, but I will weigh in with my experience. I too have had confusing information from my surgeon's nutritionist. They want me to eat alot more calories and carbs than I am comfortable with. I have eaten high protein (80-100 g), low carb (20-30 g) for my loss period and have made my goal. I started out eating about 500-600 calories a day, but several months out I added some non-starchy veggies to my protein and my calories are now about 700-800. Now that I am at goal, I am slowly adding in some fruit each day and a few more calories. Carbs and other starches are definitely a slippery slope for many of us and we need to be cautious of eating them, especially when we are trying to lose.

I advise you to listen to the people who have had success and to carefully weigh the advice of the nutritionist.

HW: 248, SW (2/17): 244, GW (10/17): 125, CW: 117-122

RNY w/ Joseph Afram: 2/28/2017; Plastics w/ Douglas Forman: Extended mastopexy, Extended abdominoplasty-5/18/2018

Liz WantsHealthForAll
on 11/9/17 3:55 am - Cape Cod, MA
VSG on 03/28/16

Ditto what everyone here says! I found the advice here was much better than the NUT, and my surgeon is thrilled with my results.

Liz 5'3" HW: 219 (BMI 38.8) SW: 185 GW: 125 CW: 115-118 (BMI 20.4-20.9) - TT and facelift 1/11/2017 - Brow and eyelid PS 12/11/2017.

WL: Pre-op: -34 M1: -17 M2: -12 M3: -11 M4: -7 M5: -7 M6: -5.5 M7: -3.3 M8: -3.3 M9: -2.5 UNDER GOAL since 10/12/2016 - in current range since 12/10/2016. Average maintenance calories 1350

on 11/9/17 5:02 am, edited 11/8/17 9:02 pm
RNY on 03/20/17

I don't think I could get in 1200 cals a day at 1 month out if you paid me.

Im not at all a serious carb counter and I'm a big time rule breaker but even I frown at bread and rice. Despite the fact they're loaded with empty calories they can turn me into a gas factory. Who needs that?

My carb of of choice is steel cut oatmeal to which I add protein but even that's more a maintenance food. At 1 month the amount of food you can actually ingest is so small you really need to focus on soft protein.

on 11/9/17 5:33 am
RNY on 08/21/12

Keep doing exactly what you are doing and ignore your NUT.

6'3" tall, male. Maintaining a loss of 280 pounds.

Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

on 11/9/17 5:54 am - Brighton, IL

If you do as she says you'll have the results many RNY patients get--substantial regain. Just nod your head and keep doing what you're doing.



on 11/9/17 6:34 am

Hi there! I am about to go into my fourth year and I feel the need to chime in because I have had a foot in both worlds.

Pre-op and during weight loss phase, I ate low carb. Very low carb. I was very successful. I skated, became a certified tae bo instructor and ran half marathons. I was not tired or sick on the low carb diet.

THEN an IT band and Hand injury happened and I couldnt exercise for about 6-8 months and I gained A LOT of weight back (like 12 lbs). I wasn't eating low carb during this time. I had to take a quarter off from work with Leave-without-pay. So I literally was eating out of my freezer or pantry.

So-in june- I get back to work, can afford food and go back to my low carb diet. I end up passing out during exertion (i.e. hiking and running) and having issues with hypoglycemia. These issues were SO BAD they landed me in the hospital 3-4 times. These issues are so bad that my blood glucose tanks if I do a 30 minute leisurely walk with hills. Like in a cemetary, where the hill is so graded that little old people can easily walk up to it to visit their deceased friends. It is so bad my endocrinologist is hinting that she might have to have the state take my driver's liscense away.

So I see HER nut *not the nut in the baratric practice* and she has me eating 6 meals a day, 2 cups of the all the food is non-starchy veg, and I get starches but they got to be complex ones (think irish oats versus perogies). And you know what? I have lost weight (2 lbs)! My head and carriage on top of my shoulders don't feel so heavy. I feel lighter again. And my blood sugar isn't doing this weird up and down thing (except for today, where I got a letter from the IRS about 2K I supposedly owe but dont have the money to pay...that is enough to raise anyone's blood sugar and blood pressure).

My point is: stick with what works. But REALIZE even when you are done losing weight, your body is still healing and changing on the inside. If things change, YOU HAVE TO CHANGE YOUR GAME. A year or two ago, I would have NEVER advocated carbohydrates of ANY kind for ANYONE. But today I am in a spot where my body NEEDS them and if I want to keep my independence, job, life...I gotta eat them. They just cant be chocolate, chips, perogies, or mac and cheese.

So if the game changes, you got to change YOUR game.

But if what you are doing is working for you-stick with it!!!

RNY Surgery: 12/31/2013; 

Current weight (2/27/2015) 139lbs, ~14% body fat

Three pounds below Goal!!! Yay !