Carbs- low carb, moderate carb, ignore carbs... a perspective

I appreciate your developed response, but obviously disagree with you on several points.

You say, "I've been on these boards and others like them for over 5 years and the most common recommendation I've seen is to keep carbs to 40 g or less during the losing phase."    This certainly does not support that "most" plans advocate 40 grams or less of carbs.  It simply indicates that it is a mantra supported by the most vocal vets.  There are many folks who have responded to this post indicating that the low carb approach was not advocated by their doctor and also references to this being treated with sarcasm and general disrespect on this board.  Consequently, it should not surprise you that there are many folks that do not agree with the low carb option, but simply prefer not to post do to the scolding that is likely to follow if they do not support the Frisco plan.  At any rate, I am not even going to bother citing research.  If you are interested I invite you to research it.  For other readers, I also invite you to research the low carb approach.  

 

You say constipation is a result of not enough fluids.  Yes, that could be a cause.  Typically from what I read on the boards, however, that the majority of people complaining about constipation do take in enough fluids.  If you are reading this and have constipation issues, do note your fluid levels.  If that is in good shape and it is still an issue, fiber or medicinal intervention are your other options.  You cited that folks under 50 need less than 25 grams of fiber and if that is not enough they need more fluid.  Personally, I need 35 or higher and my fluid intake is sky high.  I routinely drink well over 150 ounces daily that is caffeine free.  If you are reading this, again just look at your fluids and fiber for adjustments.  Or take a pill.  

I am glad to read we agree about veggies.  I do not, however, routinely see the vocal vets post that green leafy veggies do not need to be counted in carbs.  

About the cancer...  Ok, here is my history for the newbies who many not know.  I am 6'2" tall (not 6'3" as cited by Frisco).  I lost 25ish pounds preop (I think it was 26, but it is getting a little fuzzy now).  I made it to goal 8 months after surgery.  I followed the Frisco plan during months 1 and 2 and struggled hugely.  Not with hunger, but with blood sugar issues.  My blood sugar kept crashing on me, and to this day Frisco still likes to sarcastically make comments about how it is a good thing that my husband was there to "revive" me.  This is the kind of crap that I refer to as "pressure" to conform to his plan.  During the first 2 months I averaged 800 or less calories.  By the third month I added carbs back in and bumped up the calories a bit.  The carbs made a HUGE difference.  I felt a ton better and you can see from my signature below that the weight loss hummed along just fine.  During this entire process I have dealt with cancer.  I periodically had to go in for excisions and surgeries that at times were involved enough to require a brief medical leave at different points from my job.  This absolutely did not help the weight loss, and instead made it a serious barrier.  I am an emotional eater and I am here to tell you that having cancer can make you emotional.  Double that up with the fact that during healing from surgeries I was unable to exercise, it truly made it daunting at times.  But even without the exercise and eating carbs I still kept the weight loss humming along.  By month 5 I was up to 1200 calories a day.  Again, check the ticker.  As I added in calories slowly as the months progressed I had a steady weight loss.  When I was healthy enough to exercise my goal was to exercise 6 days a week.  My minimum goal was at least 30 minutes per day, but I typically did at least an hour on the elliptical or a 4-5 mile walk.  On weekends sometimes I did both on the same day.  I don't remember exactly, but during that 8 month period somewhere between 6-8 weeks of it total (broken apart in different episodes) that I was unable to exercise.  Presurgery I was diabetic and absolutely insulin resistant.  This has everything to do with why I carefully chose carbs and spaced them out post-op.  I also needed to fend of the hypoglycemia.  

I also noted earlier in this thread that I do agree that you should eat protein first and that it is a critical part of this process.  This is not a thread about substituting carbs in lieu of meeting your protein goals. It is a thread about educating yourself about what your specific needs are to determine your best path to goal.  For you, low carb worked and worked well.  I have no desire to discount nor minimize your success or the success of others that followed that plan.  I fully support the low carb approach for the folks that it works for.  But it is not the only path and it is not for everyone.  

And most of all dear readers, you are not doomed if you do not go low carb.  

First of all, there is no such thing as "The Frisco Plan."  Not to mention, referring to a common post-op plan as if it was made up by one poster and not developed over the years by numerous people with nutritional and medical training is definitely a way to demean an entire eating plan that many people have been successful with so please don't try to argue that it's just those other people who do are sarcastic and rude in an attempt to pressure others towards their POV.

In fact, what I see is a lot of sniping between you and a handful of people with sarcasm on both sides. Also, this is a very recent phenomena on OH.

What I have seen over my entire time on this board -- most of which you weren't even here so you have no idea what it was like -- is that for the most part most people are told to follow a low carb plan and there hasn't been a lot of angst about it.

Therefore there was no need for people to hide what their plans were. People ask what the post-op diet was like, people would respond, most would say "800 calories, less than 40g carbs 70-90g protein" while a few would say 100 g of carbs or only 60 g of protein or 1000-1200 calories and that would be that.

"At any rate, I am not even going to bother citing research.  "

Well of course not. Why back up your advice with actual data when you can cite anecdotes. 

"Typically from what I read on the boards, however, that the majority of people complaining about constipation do take in enough fluids."

Except, unless you are looking into their toilets, you don't know that. Yes, many are getting 64 oz. of fluids. But the advice to get that much fluid is not based on research. For some people, that is NOT ENOUGH. You can't go by that. You have to go by your pee color. And the pee color thing, unlike the 64 oz recommendation, is actually backed up by research.

"About the cancer...[details snipped]"

Except you don't know what impact cancer had on your weight loss, on your dietary requirements, etc.

That is my point. Studies look at populations and control for variables, so they can show trends that we can extrapolate from. Anecdotes are not like that.

As an example, you say that you upped your calories and you upped your carbs. That's two variables. Then you say it was the carbs that made a huge difference. But it could be the calories. In fact, based on what many people report on the boards about feeling fatigued in the first month or two and then feeling better as they up their calories, there's a very good chance it wasn't the carbs at all, that the carbs were a coincidence and it was actually the additional calories that made the difference.

In a study, they would have controlled for that in any of a number of ways. You can do that if you have a couple of hundred of people in your study. You can't do that when your n=1.

And, again, your dietary needs were probably impacted by your illness just as my dietary needs were impacted by my intense exercise. This is one reason when people ask "how many carbs/calories/protein grams" did you eat at X months?" I never just say how many. I also say how many hours I was working out and how many pounds I lost that month. Because it all interacts.

"And most of all dear readers, you are not doomed if you do not go low carb.  "

Except when you are doomed. Because if you have PCOS, metabolic syndrome, etc., or don't work out a lot, or have other conditions that make carbs problematic for you, then not going low carb is going to negatively impact your results. OTOH, if you go low carb, and you don't have any conditions that make carbs problematic, nothing bad happens.

This is why so many programs have a low carb approach. They didn't just decide to do this because they felt like torturing people. They do it this way for a reason. They do it this way because it's the safer approach. It works for more people.

Do I know people who haven't done it and have still lost weight and gotten to a normal BMI? Sure. I know about 5. Do I know people who haven't done it haven't gotten to goal and later struggled with regain? Sure. I know ..... too many to count.

So while I'll never start an entire thread urging people to go low carb (other people's choices just aren't that important to me), I'm not going to let misinformation slide -- because misinformation make me cranky -- and I'm not going to tell people that they can eat carbs if they want to and be fine. Because that's not what I've seen.

What I've seen over the past 5+ years is that low carb is a safer bet and that many more people struggle when they eat more than the barest amount of carbs than do not struggle. And that studies show you lose weight faster, the lower your carbs are. And that losing weight faster is more rewarding (also confirmed by studies) and that people who lose weight faster are more likely to get to goal.

So, basically, even though some people can get away with it, going higher carb is not a safe bet. It's playing with fire. Sure, you might not get burned, but why take the chance if you haven't got some kind of medical condition that's requiring it? Especially after you've paid someone to cut out 85% of your stomach.

I thought this was an interesting find, though I can't comment on the entire article (I haven't read it all yet - it costs money!) BUT, this discussion spurned my curiosity to search for a recent study on the topic. I'm very new to the WLS process, but I have to say that as a great big fat person, I don't crave deli meat, nonfat FAGE yogurt, or protein supplements; for the most part, I want deliciously flavorful foods that have fat and carbohydrates. I feel like all humans want those things, generally speaking, and that obese folks have trouble resisting them, and thus should practice avoidance as much as possible. Maybe the equation is just that simple - I don't know. I am not diabetic and didn't really have risk factors as a pre-op, other than I was 'morbidly obese' with a family history of high BP.

Anyway, here! http://care.diabetesjournals.org/content/early/2013/02/07/dc12-1912.abstract.html?papetoc

I will see if I can log in to an online research database and find the PDF version, but the abstract/conclusion is what I noticed.

 

Except that I am not advocating a "high carb" diet.  I am just saying that a "low carb" diet is not a requirement for all folks.  Even my higher carb intake than what is typical on this forum would not by any stretch of the imagination b considered a high carb diet.        I believe the RDA cites 300 grams of carbs for a 2,000 calorie diet (I may be wrong, feel free to confirm somebody).  If you read my posts I personally try to average around 150ish, with net carbs being closer to a 100.   My current daily calorie goal is 1,600 or 20% less than the 2,000 calorie diet.  Given that my carb target would be 240 grams, not 150.  So I am not high carb for sure... but certainly not extreme low carb.  

I also do not dispute that eating a lot of carbs triggers hunger and cravings.  This is why I talk about not too many carbs at one sitting, and good carbs versus bad carbs.  

I do appreciate the link to the article- interesting!

Hi - I wasn't insinuating that you were advocating anything - I was just responding to the overall thread title and the conversation about carbohydrates. Still can't find the damned PDF... ah well.

Ok, a few talking points here:

 

1.  You stated it was a recent phenomenon, this disagreement between the low carb approach and a more balanced approach.  I disagree.  I have been on the boards over 3 years now.  (My first login was changed since I used my most common one and somebody at work figured out it was me on a professional education site, so I changed it here.)  This debate has been around for sure since then.  I bet also prior to that given the posts and PM's I receive from Carmelita, who has been around far longer than I.  So I am not buying that.  

2.  I am simply not going to bother citing research about the non-low carb approach.  You may summarily dismiss this or use it to strengthen your stance iif you desire.  This is widely available and I simply am not going to take the time to document- particularly for a poster that has no desire to see the other perspective.  

3.  Now your comments about my other health issues are simply out of line.  WTF do you know about me and my hypgoglycemia and cancer status?  How do I know that it was not the added calories I added instead of my increased carbs?  Because I added carbs without increasing calories and my blood sugar stabilized.  I know this not simply because I felt better, but because I checked the levels, carefully logged foods, and overall it is not rocket science.  So yes, I am quite certain it was the carbs and not the added calories.  I am not even going to get started on the cancer other  than to say beyond a shadow of a doubt that the periods leading up to and during the medical leaves I had to switch my goal to 'just don't gain" and then work like hell to meet that goal.  I sometimes I gained a few pounds, and sometimes I broke even.  I never lost during these times.   I think it is just plain ****ty of you and the other vocal vets to try to minimize my success in weight loss to the fact that I had cancer, simply because ya'll don't like the fact that I did so well not subscribing to your plan.  Really, really ****ty of ya'll and it says a lot about your character.  

4.  Have you read the posts from Frisco and Elina that are directed toward me?  Go back and read.  My posts always start out sticking to comments and thoughts about plans or the weight loss journey.  Frisco in particular chimes in and switches the discussion from a thread about plans to personal attacks.  I think when he makes comments like good thing my husband was there to revive me with a jelly sandwich or tries to  in essence blame my weight loss on my cancer status that it is uncalled for, petty, and indicative of his frustration that the board cannot be monopolized by only his views.  Don't even get me started about his and Elina's habit of starting threads about me knowing that since I am blocked I could easily miss them and am unable to post any type of response.   I do agree with you, I at times will respond to that type of bull**** with sarcasm though.  

5.  Regarding fluids.  So now you are an expert on other people's fluids as well.  If I read a poster who states that they are getting in their fluids, but still having constipation issues I have no reason to ask them if their urine is yellow.  If they are going low carb then they either need fiber or start taking medicine for it.  It is what it is.  It is just a commonly documented negative effect of a low carb diet.

6.  Not all people need to follow the low carb plan and they are not doomed if they don't.  Some people need to, and I have no issue with that at all.  Some people don't, and that obviously is not an issue for me.  But you know what an issue is for me?  Presenting the low carb plan from the vets to the newbies that it is the ONLY way and that they will FAIL if it is not followed.  The newbies are already scared to death that wls will not work for them and this intentionally preys on those fears in an effort to perpetuate the plan of one doctor.  I strongly suspect that the purpose of this entire board is simply to drum up business for Cirangle, hence some of the behavior of the board being so anti- Cirangle plan.  Frankly, if he is that good of a surgeon then that type of crap would not be needed.  Not knocking him as a surgeon though, because the behavior of some of his patients may not reflect his practice.  

7.  You wrote that is is a "safer" approach.  Hmmm....   blood sugar can crash.  Not safe.  Constipation to the point that folks here commonly report impacted bowels and painful trips to the ER.  Not safe.  Nutritional deficiencies.  Not safe.  Fainting/light headed issues reported.  Not safe.  

So to the readers, once again- you are not doomed if you don't follow the Frisco plan.  And I call it the Frisco plan only because it is a short version of saying less than 40 carbs, less than 800 calories, blah blah blah.  Folks *****ad the posts know exactly what I am talking about when I do this.  

This kind of arguing is called Strawman arguing.

I hate low carb diets. Yes I said it and that's the truth. I ate carbs during weight loss phase and I eat them now in maintenance. I have not gained any weight and I'm 4.5 years out. I will never eat a soup diet either like some on here. I eat well balanced meals and even have green juice all the time which has quite a bit of fruit in it. I feel totally rotten on low carb and I work out a lot. And no I didn't just start working out when I got surgery but have been at it for 25 years. I got fat from processed junk carbs like fries, chips, cake, pie, ice cream, pizza, burgers, wings, etc. Eating healthy, whole foods helps my bowels and fuels my workouts. And yes that includes potatoes, corn, small amounts of rice and pasta and oats as well. I don't however drink much alcohol. I just don't care for it much. So that's my story and I'm sticking to it!  

 

Laura

You have been maintaining well for quite a while now!  Congrats!!  I do green juice too- had blood work just prior to starting, and then later after I had been at it a while.  It really made a difference!  

I'm with you. I make sure I get in all of my water and protein - the rest of my calories go for complex carbs and some fat. (Which I'm working on increasing - scary stuff for someone who's been on a diet of some sort for the past 45 years)

I didn't have this surgery so I could live on lean meat and the occasional bite of a veg. I had it to get control of constant, raging hunger and to have a sense of "full" on an amount of food somehow related to a normal portion. Ok, what is a "normal portion" to me now is much smaller than what most people i know eat, but i'm totally fine with that, and the weight and inches are still dropping slowly. Getting off my BP, cholesterol and pain meds were a major bonus.

So - I eat SOME chicken and fish, but more dairy and legumes. I also eat small portions of veg, fruit, whole grains - and the very occasional few bites of dessert. Yes, I might lose a little faster if I did things differently, but would it matter in the end? I don't think so.