Exercise, Nutrition, WLS, and Cooking Q & A - 2/27/2014

Sorry I have been away for a couple of days. Its been a very busy week and next week should be just as bad. If you have questions, this is the place to get some answers.

If you have questions about exercise, nutrition, WLS, or cooking...

Let's hear 'em!

I am pre-op, don't have a date yet.  I'm going through the six months of doctor supervised diet and exercise. I have been working with personal trainers since January 2012. Anyway, what do you recommend that I work on to make recovery easier?  I'm afraid to tell my trainer that I am planning surgery, but I will have to at some point!

Those 6 months will zoom by before you know it.  Working with a personal trainer is a great step forward - the more physically fit you are the healthier you'll be for the surgery.  I'm big on plain jane walking; it's a great fat burner, plus it'll help directly after surgery with the gas pains.  It's also the only exercise you'll be allowed to do for a month to six weeks after surgery.

Also start logging your food in something like MyFitnessPal.com.  The most common eating plan for post VSG'ers is high protein, low carb.  You can set up calorie/protein/carb/sugar, etc. goals in the tool and see how you're doing throughout the day.  My goals are set for 80 grams protein, less than 40 grams carbs, less than 800 calories per day.  Right after surgery your calorie intake will likely be lower than that though.

Water - super important!  right now there are a couple of people on these boards that have been hospitalized due to dehydration, and that's not good!  MyFitnessPal will also allow you to track your water intake - aim for 10-15 glasses a day for weight loss mode; more if you're exercising heavily that day.

Planning - your life will not magically change overnight with the surgery.  The day of the surgery is when the real work begins.  Start now figuring out why you got fat in the first place and deal with it.  Are you a binge eater?  Do you have triggers (mine are doritos and peanut butter cups; just one and I want to eat for days)?  Emotional eater?  Did you have a trauma that started the weight gain?

If you're at a loss, try journaling every day with your emotional state, how tired you are, and how easy it was to eat according to plan.  And do get therapy if you need to - sometimes a third party can make the light bulb go on for you.

Just like surgery won't fix you overnight, don't try to do all of these things in one day.  It took years for us to get fat; it takes months to lose the weight, and the rest of our lives to keep it off.  Good luck to you!

Thank you for the awesome info. I appreciate it very much. 

Focus on building muscle and don't do a lot of cardio and I will explain why. When you start the pre-op liquid diet all the way through to the return to full foods you actually lose quite a bit of muscle because while you are getting in protein, you aren't exercising and your protein intake is not that high. So you need to build as much muscle as you can before surgery and then once you start your pre-op diet take a supplement like Scivation Xtend to preserve those muscles throughout your surgery and recovery. Also focus right now on protein protein protein. Your body needs protein to recover from surgery. Give it as much as you can now. Get used to eating protein first as that is your life now. Eat all your meat, then your veggies and now while you still can whatever else is on your plate. But your focus from here on out should be on the most protein dense then nutrient dense foods, then whatever else you can fit in. You may find just changing that little bit will make a huge difference in how much you lose before surgery.

Now the cardio. Its a bit counterintuitive because we think cardio burns fat, which arguably it does, it depends on the intensity and the duration, intervals, etc. However it also improves cardio function which actually lowers your resting metabolic rate. The lower your resting metabolic rate the slower you will lose post op. I started with cardio early in my recovery and have hit it hard ever since. But I have been working on my last 20lbs for about 3 months now. I have lowered my resting metabolic rate and increased my caloric intake so that they are so close together that I am not losing very fast at all. If I were to do it all over again, i would have focused on weight training with much less cardio until later because more lean muscle mass burns more calories at rest (i.e. a higher resting metabolic rate). That is why body builders can eat 3000-6000 calories a day and maintain a 15-20% body fat.

I would tell your trainer about the surgery and tell him what I just said about recover and post-surgery weight loss that way he can structure your program between now and then to achieve these goals.

All of that being said you may find with these couple of changes that you lose quite a lot of weight in the next 6 months. I don't know what your diet looks like, but maybe with a few more small changes you could become a fat burning machine. If had known then what I know about diet, nutrition, and exercise, I probably would not get the surgery. The rule of thumb is you lose weight in the kitchen and you get fit in the gym. So make some small sustainable changes and you will see some very big results. And don't be afraid to challenge yourself. Let's say for example you drink 8 regular cokes per day, every day and you are maintaining your weight. What if for the next week you drank only 7, but make sure you keep count and hold yourself accountable, meaning make sure you make that cut every day without exception. That is 1,750 calories per week and you know what that would mean if you were maintaining at 8 cokes a day? That would result in a 1/2 lb loss on the scale. You would have to walk for about 5 hours to burn 1,750 calories. So you can see how you lose weight in the kitchen. Now in the next week you drop to 6 cokes and so on until you are not drinking coke any more. Small sustainable changes coupled with a solid eating strategy. Eat protein first, then veggies, then whatever else you want if you are still hungry. If you are not hungry stop eating. Do not finish everything on your plate, leave a little there each time on purpose and get used to being ok with it because after surgery you won't have a choice. Another strategy, whatever carbs you are eating in a day, try to do them after a workout and not other times of the day. So lets say you like to eat a whole bag of chips (you will need to stop this and hopefully you would use the strategy above to accomplish that) but I am not saying not to do that, just do it after a workout, you will gain muscle by doing that. Because insulin spikes when you eat that many carbs and insulin is an anabolic (muscle building) hormone, but you also have to have protein with it and ready to go to make that happen. More muscle = more calories burned. More calories burned (as long as you are not out eating your calories) means body weight lost.

Thank you so much. I will keep this post and refer to it frequently. It raised a question.  You refer to resting metabolic rate. Is that the same as resting heart rate?  I thought that exercise actually speeds up your metabolism. Is metabolism different than metabolic rate?

They are not the same but they are related. So both your resting metabolic rate and your resting heart rate will go down as you get more fit. Your resting heart rate is the rate at which your heart beats when at rest. Your resting metabolic rate is the number of calories you burn while at rest. So when you are overweight your heart has to beat more to push the blood through the body mass. As you become more fit and your lose weight your heart does not beat as often therefore your resting heart rate goes down. In correlation as you get more fit and your cardio capacity improves (also contributing to a lower heart rate) you will burn fewer calories at rest. Metabolism is a general term describing how your body processes food and other digested substances (like medicines). If you are a slow metabolizer things like sleeping pills tend to stay with you longer than if you were a fast metabolizer. So as over weight people we tend to probably have slow metabolisms to begin with and increasing them is quite difficult. Yes we do speed up our metabolism when we exercise because our heart rates go up and our heart rates go up because our muscles are moving and requiring more oxygen and nutrients which are delivered by our blood. This is why things like caffeine and green tea can make metabolism claims because they raise your resting heart rate. The net effect on a daily basis is quite small but its like interest in a bank if you do it long enough it adds up.

Thank you. That makes sense. 

Hi Keith

First I want to say THANK YOU for being such an inspiration. I first started coming here in October 2012 and I remember seeing your posts then. I think you were pre-op or just recently sleeved. I stopped coming for a while and when I returned there you were looking AMAZING and having more information that I thought humanly possible!  So here is my question. I do NOT like to exercise but I have committed to walking a mile a day for the last month. I have been enjoying it and can see adding more walking soon. I am one of those people who will lose well for a few weeks and then hit a stall. I am in a stall (nothing lost this week) and today I am going for my quarterly cortisone injections in my knees so my dr will tell me to take it easy for the next 5 days and I am worried about losing my momentum and causing  the stall to be prolonged. So what can I do to 1) help break a stall when it happens and 2) exercise when I shouldn't.

This is not a very popular answer but it works. When you stall and by stall I mean more than 3 days, increase your calorie intake by about 100-200 calories from healthy fats and coconut oil. It doesn't take much to hit that so it doesn't mean go crazy and it doesn't mean eat anything with carbs. First make sure you are getting your water numbers (100oz, at least 70-80g of protein, make sure you are low carb (less than 40g) and make sure you are getting enough sleep. We "stall" for lots of reasons and sleep is a big one.

As for exercising when you shouldn't...I assume you mean an injury or something where you need some rest, its simple, don't exercise. But an injury shouldn't take more than 4 days to recover from to where you can return to exercise, if it does you need to see a doctor. If exercise you shouldnt as in time of day, that doesn't matter too much but you should have an eating pattern. You should always eat some protein about an hour before exercise and then within an hour after exercise. Does that answer your question or maybe I am not understanding that 2nd one?