Exercise, Nutrition, WLS & Cooking Q&A - 1/6/2014
I have been slacking off on these and we have lots of new members.
I am not a certified personal trainer (yet...I will be soon), I am not a certified nutritionist (yet...I will be soon), and I am not a life coach (but I will be soon), however I am 16 months post-op, I have lost 181 lbs, I have improved my physical capability about 400% (that's just a guess), and I am a pretty good cook.
So if you have any questions about exercise, nutrition, weight loss surgery, or cooking. I am here to help. Plus other members will chime in too so you are not just stuck with my answer you can get other perspectives on your issue.
So if you have questions, I will get you an answer!
I don't really consider myself a vet yet but I do have a fair amount of experience.
OK, so 3 shakes per day is going to be around 450-800 calories depending on the brand, size, flavor, what you mix it with, etc. The idea from now until you hit your goal is to be at an extreme caloric deficit. So even after you return to full food you will only be getting between 600 and 800 calories per day, so calorically speaking you are are hitting post-op numbers right now. Post-op you will be exercising, so the short answer is yes. If you burn all of your consumed calories with exercise, the rest is gravy, and will be about 2400-3200 calories per day (everyone is different depending on your resting metabolic rate which is higher when you first start than when you end). After losing 180 lbs mine is about 1900 calories per day.
So walking/jogging for 45-60 mins you are burning somewhere between 100 and 300 calories depending on the mix and resistance. It is never as much as the treadmill says it is. To get really accurate number on calorie burn requires you to wear a heart rate monitor and even they are not 100% accurate.
So yes the amount you are eating is fine for what your objective is which is to lose weight. Now my advice to you would be to stop jogging for now. Just walk, if you want a bit of a challenge and to raise your heart rate a bit, add a bit of incline on the treadmill. But jogging will increase your cardio capacity (which yes is a good thing and you will focus on that later) but will also bring your resting metabolic rate down sooner than you want it to. Plus at your current weight you are risking injury and some unnecessary damage to your knees, hips, and ankles.
If you really want to do yourself a huge favor, only walk for 15 mins and spend the rest of the time lifting weights. More muscle mass you have after your surgery the more calories you will burn at rest. Save the cardio for when you return to exercise post-op. Right now muscle is king in this process. You may also want to consider taking some Branch Chain Amino Acid supplement like Scivation Xtend or a similar product whcih will help you preserve your muscles through the pre-op diet and on through your post-op diet phases. It is zero carb and low cal and will fit into your clear liquids just fine.
I like the Xtend, the flavor is good. I tend to use a bit more water than it calls for because it is very sweet.
Don't be mind blown and my opinion is not a popular one but I know that it happens a lot. You have to find what works for you. Swimming is great exercise because it uses your whole body, but it is also cardio. You want to build muscle. And don't get me wrong you are not reducing your metabolic rate just because of the exercise. Your resting metabolic rate is going to come down as you lose weight. But I know from my experience that the more my cardio capacity improved, the more my weight loss slowed down and now when I measure my resting metabolic rate its down around 1800-1900. So also to be clear I am not saying not to do it, I am saying don't be in a hurry to do it. Work on muscle now because that is how you keep your resting metabolic rate higher over the long haul. Now that being said it will also slow your initial weight loss a small amount so instead of dropping 21lbs per week you may only be dropping 18-20 (don't expect those number, that was just an example).
Hi Keith, I hope you can help me.
I started my 2 week preop diet today. Coincidentally, I just started an exercise program as well. I'm pretty deconditioned so I've only been doing 20 minutes on a stationary bike 3X/week and jogging in the pool the other 3 days. My trainer just added a series of upper body weight exercises which is where I feel I may be running into some problems.
Today after my last series of reps on the last machine my arms felt numb and weak, like limp spaghetti. I then developed a tremor in my hands. I went into a full blown panic attack where I just walked back and forth over the gym floor and tried to breathe deeply. The weakness wasn't going away. One of the trainers asked me if I was alright and I told him how i was feeling. He asked, "When did you eat last?" I had had my first protein shake at 8:30 this morning and by then it was noon. He told me that I was probably out of fuel and to go home and eat something.
I was still upset so I stopped at my surgeon's office on the way home. Luckily, she was available. She took my blood pressure (which was high) and told me that it was now OK for me to eat vegetables (her preop diet is liquids only) and that I should add an extra protein shake. She also told me to drink a protein shake about 30 minutes or so before my workouts. Other than that, she told me not to worry and that I was OK'd for exercise.
Now I'm scared that I might be hurting myself in some way. Should I scale down on the number of reps per machine? My upper body is pretty weak and I feel myself getting tired easily. Should I start using a lower weight? I also worry that my body won't have the fuel it needs to sustain a workout with weights. My assumption was that my body would just use the glycogen stored in my iiver--perhaps I'm wrong?
Sorry to write a book. I just don't want to have a panic attack every time I try to use the weight machines. I want to stay committed to a fitness program, even if I can't do much in the beginning.
Thanks in advance for your help! 
OK, there are a couple of things going on here but for the most part I think you will be fine. Your timing of starting the diet and the exercise around the same time is unfortunate. You have to train your body to get used to burning fat for fuel and that takes a couple of weeks so expect to feel fatigued like this every time. You just don't have to panic is all. Even before I got to the part where your doc said to add a protein shake I was already thinking that so my recommendation was going to be to add one. You definitely should be eating before your work out but with a full functioning stomach I would say more like an hour before but listen to your doc. Just sometimes wtih cardio you may feel it sloshing around in your stomach and may vomit. After your surgery liquids will go through fairly quickly so you can shorten the time, but right now I would say about an hour before your workout drink a shake and then within 30 mins AFTER drink that shake the doc told you to add, that will help a lot with recovery.
It is also possible that you started a bit high on your weights and you may consider bringing them down 10-15% and see what that does for you. You want to make sure you are still being challenged and that you are sore the next day because that is how you know you are using the right weights, you are trying to breakdown muscle to build new. You should feel fatigued when you are done. I am wiped out after my exercise and I am at full food and I eat before and after as I suggested above.
Now your trainer my try to get you to eat carbs and for an athlete, he is right, but you are not an athlete, at least not yet. If he is not familiar with the strategy here to get you to lose weight, you need to educate him so he can make adjustments to his exercise strategy that he plans for you. He needs to understand that you need to be eating low carb/keto for a very long time. As such you need to be doing lots of walking and HIIT type training whether it is cardio or weights, they should fit a similar model. This is how you will burn the fat the fastest.
Your BP is going to play a role in this fatigue too. Overweight people typically have higher BPs and as such you will want to make sure you are taking big cleansing breaths as you rest between reps and sets or when you finish cardio. During cardio make sure you find a pace in which you time your breathing so you don't get worn out.
Two more pieces of advice. Make sure you are getting plenty of sleep. If you can exercise early in the morning after you sleep you will not get as fatigued but also I will tell you motivation is more difficult in the morning. Make sure to give yourself enough time get that shake in an hour before you start. I get up at 5am make my shake, drink it, and then lay back down until 5:45 when I have to leave for my 6am workout before work. After I get ready for work I eat my breakfast. The other thing is look into some recovery type of supplement. The one I use is called Scivation Xtend. Start drinking it now and drink it all the way through your surgery and post-op diet phase, you can continue after that if you like. It has Branch Chain Amino Acids (BCAA) as well as other things and helps to build muscle and speeds recovery. It will also preserve your muscle as you go through this pre-op phase, your liquids and such because without it you will lose muscle.
Oh, the numbness is from pushing with your hands. It happens every time I bench whether I use gloves or not, but gloves do help. Look for weight lifting gloves that have a firm palm and it will help distribute the load better. The weakness is because you used up your glycogen stores and that is a good thing. Yes carbs are the fastest way to replenish and if you were working out twice a day we might look into increasing carbs post-op but you don't need to worry about glycogen just yet.
So I tried your suggestion on toasting oatmeal for my yogurt and it is good, but I do like a little variety. I have been putting a Tbsp of honey crunch wheat germ in my yogurt. Here are the stats: cal 25, carbs 4, and protein 2. I have no problems with staying under 40 carbs but just wanted to get your opinion since I am still new at this journey.
M&M
Wheat germ is good fiber, as long as you are not gluten intolerant the macros on it look pretty good to me. Oats are typically gluten free which is why I used them (not gluten intolerant but like to keep it to a minimum). Just pay attention to your scale, if you suddenly see a big stall, try cutting that for a few days to see what happens.
